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J Infect. 2007 May;54(5):446-53. Epub 2006 Sep 26.

Antibiotic treatment of community acquired pneumonia varies widely across Germany.

Author information

1
Institute of Social Medicine, Medical University Schleswig-Holstein, Campus Luebeck, Beckergrube 43-47, 23552 Luebeck, Germany. yvonne.kohlhammer@gsf.de

Abstract

Community Acquired Pneumonia (CAP) is a frequent and potentially fatal infectious disease which, in the majority of cases, needs an antibiotic intervention.

OBJECTIVES:

Aim was to evaluate antibiotic treatment patterns regarding all types of mono- and combination-therapy throughout the local clinical centres (LCCs) represented in the German competence network CAPNETZ (=Community Acquired Pneumonia Network) and to identify clinical indicators for regional differences.

METHODS:

We analysed outpatients and inpatients recruited between March 2003 and April 2005. Patient and treatment details were registered online using standardised data entry forms. A logistic regression model was issued for the 4 most frequently applied antibiotics, adjusting for potentially relevant confounders.

RESULTS:

The study sample consisted of 3221 patients at the age of 18 to 102 years. Overall, aminopenicillins plus betalactamase inhibitor (20.4%), fluoroquinolone (17.0%), macrolides combined with cephalosporins third generation (10.6%) and cephalosporins third generation (8.9%) were most frequently prescribed. After control for potential confounders, significant treatment differences remained between study sites. Regional variability of antibiotic CAP-treatment could not be attributed to a number of clinical or sociodemographic factors.

CONCLUSIONS:

The presented treatment variability ranges within given guidelines, but indicates the need for an ongoing implementation of evidence-based guidelines in order to avoid potential negative clinical or economic consequences.

PMID:
17007933
DOI:
10.1016/j.jinf.2006.08.010
[Indexed for MEDLINE]

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