Timing of antibiotics in CAP

Abstract

Purpose

Timely administration of antimicrobials in patients with community‐acquired pneumonia is now a standard of care. The purpose of this paper is to present a large observational study to understand the issues that result in a delay in the administration of antibiotics to patients with community‐acquired pneumonia

Design/methodology/approach

This prospective study involved all six hospitals in the Edmonton area: patients were enrolled at the time of hospitalization if they were adults aged ≥17 years with a clinical presentation consistent with community‐acquired pneumonia. A retrospective chart review was performed to determine the reasons why it took more than eight hours to administer the first dose of antibiotics.

Findings

The paper finds that of all 3,394 hospitalized patients, 646 (19.0 percent) received antibiotics over four hours after admission to the emergency department and in most instances the delay was more than 12 hours. A total of 30 percent of the delays were justifiable – 17 percent due to diagnostic indecision and 13 percent due to recent receipt of an antibiotic at home or at another institution prior to transfer. All the other delays were unnecessary and easily correctable. In this paper the data indicate that only 5.6 percent of 3,394 patients had an adequate reason for delay in antibiotic administration. Thus a reasonable target for timely administration of antibiotics is at least 90 percent of the patient population.

Originality/value

The strengths of this study lie in its large number of patients, inclusiveness and real world context.

Citation

Reza Shariatzadeh, M. and Marrie, T.J. (2007), "Timing of antibiotics in CAP", International Journal of Health Care Quality Assurance, Vol. 20 No. 4, pp. 341-345. https://doi.org/10.1108/09526860710754406