Blasi Francesco, Garau Javier, Medina Jesús, Ávila Marco, McBride Kyle, Ostermann Helmut
Respir Res. 2013 Apr 15;14(1):44. doi: 10.1186/1465-9921-14-44.
Data describing real-life management and treatment of community-acquired pneumonia (CAP) in Europe are limited. REACH (http://NCT01293435) was a retrospective, observational study collecting data on the management of EU patients hospitalized with CAP.
Patients were aged ≥18 years, hospitalized with CAP between March 2010 and February 2011, and requiring in-hospital treatment with intravenous antibiotics. An electronic Case Report Form was used to collect patient, disease and treatment variables, including type of CAP, medical history, treatment setting, antibiotics administered and clinical outcomes.
Patients (N = 2,039) were recruited from 128 centres in ten EU countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Turkey, UK). The majority of patients were aged ≥65 years (56.4%) and had CAP only (78.8%). Initial antibiotic treatment modification occurred in 28.9% of patients and was more likely in certain groups (patients with comorbidities; more severely ill patients; patients with healthcare-associated pneumonia, immunosuppression or recurrent episodes of CAP). Streamlining (de-escalation) of therapy occurred in 5.1% of patients. Mean length of hospital stay was 12.6 days and overall mortality was 7.2%.
These data provide a current overview of clinical practice in patients with CAP in EU hospitals, revealing high rates of initial antibiotic treatment modification. The findings may precipitate reassessment of optimal management regimens for hospitalized CAP patients.
关于欧洲社区获得性肺炎（CAP）实际管理和治疗的数据有限。REACH（http://NCT01293435）是一项回顾性观察性研究，收集了欧盟因CAP住院患者的管理数据。
患者年龄≥18岁，于2010年3月至2011年2月期间因CAP住院，且需要住院静脉使用抗生素治疗。使用电子病例报告表收集患者、疾病和治疗变量，包括CAP类型、病史、治疗环境、使用的抗生素和临床结局。
从十个欧盟国家（比利时、法国德国、希腊、意大利、荷兰、葡萄牙、西班牙、土耳其、英国）的128个中心招募了患者（N = 2039）。大多数患者年龄≥65岁（56.4%），且仅患有CAP（78.8%）。28.9%的患者发生了初始抗生素治疗调整，某些组（有合并症的患者；病情更严重的患者；有医疗保健相关肺炎、免疫抑制或CAP复发的患者）更有可能出现这种情况。5.1%的患者进行了治疗简化（降阶梯）。平均住院时间为12.6天，总死亡率为7.2%。
这些数据提供了欧盟医院CAP患者临床实践的当前概况，显示出初始抗生素治疗调整的高发生率。这些发现可能促使对住院CAP患者的最佳管理方案进行重新评估。
