3rd Department of Internal Medicine, National and Kapodestrian University of Athens, Medical School, Athens, Greece.
Eur Rev Med Pharmacol Sci. 2012 Jan;16(1):1-9.
Community acquired pneumonia (CAP) remains an important cause of morbidity and mortality, with significant economical and social cost. Adherence to the international guidelines for the empiric treatment of CAP can improve patients' prognosis, reduces the need and shortens the length for hospitalization. However, adherence to guidelines varies among physicians.
We performed a prospective observational study in 252 immunocompetent hospitalized patients so as to investigate whether the 2003 Infectious Diseases Society of America update of practice guidelines and the Greek national guidelines for CAP are followed by chest physicians working in "Sotiria" General Hospital in Athens, Greece.
Total mortality rate was 12.3%. One hundred twenty (48%) patients were admitted to the Hospital, despite the fact that they were classified as risk class I or II according to the Fine criteria. Accordance to CAP guidelines, as far as the initial antibiotic regimen is concerned, was found to be poor (152 patients, 60%). A trend towards a shorter length of hospitalization was observed in patients treated with an initial antibiotic regimen in accordance to guidelines compared to those receiving an initial antibiotic regimen in discordance to guidelines.
The implementation of CAP guidelines by chest physicians working in a Greek Hospital for Thoracic Diseases is poor. Improvement of adherence to guidelines may shorten the length of hospitalization and reduce the financial burden for the National Health System.
社区获得性肺炎（CAP）仍然是发病率和死亡率的重要原因，具有重大的经济和社会成本。遵循国际 CAP 经验性治疗指南可以改善患者的预后，减少住院需求并缩短住院时间。然而，指南的遵循情况因医生而异。
我们在 252 名免疫功能正常的住院患者中进行了一项前瞻性观察性研究，以调查在希腊雅典的“Sotiria”综合医院工作的胸科医生是否遵循了 2003 年美国传染病学会更新的实践指南和希腊国家 CAP 指南。
总死亡率为 12.3%。尽管根据 Fine 标准，120 名（48%）患者被归类为风险 I 或 II 级，但仍被收入医院。根据 CAP 指南，初始抗生素方案的一致性较差（152 名患者，60%）。与不符合指南的初始抗生素方案相比，符合指南的初始抗生素方案治疗的患者住院时间更短。
在希腊胸科疾病医院工作的胸科医生对 CAP 指南的执行情况较差。改善对指南的遵循可能会缩短住院时间并减轻国家卫生系统的财务负担。
