Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study
Abstract Background Norwegian guideline recommendations on first-line empirical antibiotic prescribing in hospitalised patients with community-acquired pneumonia (CAP) are penicillin G/V in monotherapy, or penicillin G in combination with gentamicin (or cefotaxime) in severely ill patients. The aim...
Published in: | BMC Pulmonary Medicine |
---|---|
Main Authors: | , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
BMC
2020
|
Subjects: | |
Online Access: | https://doi.org/10.1186/s12890-020-01188-6 https://doaj.org/article/9b37cfc2843448a291a43ec794ca2a38 |
id |
ftdoajarticles:oai:doaj.org/article:9b37cfc2843448a291a43ec794ca2a38 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:9b37cfc2843448a291a43ec794ca2a38 2023-05-15T17:39:25+02:00 Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study June Utnes Høgli Beate Hennie Garcia Kristian Svendsen Vegard Skogen Lars Småbrekke 2020-06-01T00:00:00Z https://doi.org/10.1186/s12890-020-01188-6 https://doaj.org/article/9b37cfc2843448a291a43ec794ca2a38 EN eng BMC http://link.springer.com/article/10.1186/s12890-020-01188-6 https://doaj.org/toc/1471-2466 doi:10.1186/s12890-020-01188-6 1471-2466 https://doaj.org/article/9b37cfc2843448a291a43ec794ca2a38 BMC Pulmonary Medicine, Vol 20, Iss 1, Pp 1-9 (2020) Community-acquired pneumonia Antibiotics Guideline Clinical outcome Norway Antibiotic stewardship program Diseases of the respiratory system RC705-779 article 2020 ftdoajarticles https://doi.org/10.1186/s12890-020-01188-6 2022-12-31T10:36:43Z Abstract Background Norwegian guideline recommendations on first-line empirical antibiotic prescribing in hospitalised patients with community-acquired pneumonia (CAP) are penicillin G/V in monotherapy, or penicillin G in combination with gentamicin (or cefotaxime) in severely ill patients. The aim of this study was to explore how different empirical antibiotic treatments impact on length of hospital stay (LOS) and 30-day hospital readmission. A secondary aim was to describe median intravenous- and total treatment duration. Methods We included CAP patients (≥18 years age) hospitalised in North Norway during 2010 and 2012 in a retrospective study. Patients with negative chest x-ray, malignancies or immunosuppression or frequent readmissions were excluded. We collected data on patient characteristics, empirical antibiotic prescribing, treatment duration and clinical outcomes from electronic patient records and the hospital administrative system. We used directed acyclic graphs for statistical model selection, and analysed data with mulitvariable logistic and linear regression. Results We included 651 patients. Median age was 77 years [IQR; 64–84] and 46.5% were female. Median LOS was 4 days [IQR; 3–6], 30-day readmission rate was 14.4% and 30-day mortality rate was 6.9%. Penicillin G/V were empirically prescribed in monotherapy in 51.5% of patients, penicillin G and gentamicin in combination in 22.9% and other antibiotics in 25.6% of patients. Prescribing other antibiotics than penicillin G/V monotherapy was associated with increased risk of readmission [OR 1.9, 95% CI; 1.08–3.42]. Empirical antibiotic prescribing was not associated with LOS. Median intravenous- and total treatment duration was 3.0 [IQR; 2–5] and 11.0 [IQR; 9.8–13] days. Conclusions Our findings show that empirical prescribing with penicillin G/V in monotherapy in hospitalised non-severe CAP-patients, without complicating factors such as malignancy, immunosuppression and frequent readmission, is associated with lower risk of 30-day readmission ... Article in Journal/Newspaper North Norway Directory of Open Access Journals: DOAJ Articles Norway BMC Pulmonary Medicine 20 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Community-acquired pneumonia Antibiotics Guideline Clinical outcome Norway Antibiotic stewardship program Diseases of the respiratory system RC705-779 |
spellingShingle |
Community-acquired pneumonia Antibiotics Guideline Clinical outcome Norway Antibiotic stewardship program Diseases of the respiratory system RC705-779 June Utnes Høgli Beate Hennie Garcia Kristian Svendsen Vegard Skogen Lars Småbrekke Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study |
topic_facet |
Community-acquired pneumonia Antibiotics Guideline Clinical outcome Norway Antibiotic stewardship program Diseases of the respiratory system RC705-779 |
description |
Abstract Background Norwegian guideline recommendations on first-line empirical antibiotic prescribing in hospitalised patients with community-acquired pneumonia (CAP) are penicillin G/V in monotherapy, or penicillin G in combination with gentamicin (or cefotaxime) in severely ill patients. The aim of this study was to explore how different empirical antibiotic treatments impact on length of hospital stay (LOS) and 30-day hospital readmission. A secondary aim was to describe median intravenous- and total treatment duration. Methods We included CAP patients (≥18 years age) hospitalised in North Norway during 2010 and 2012 in a retrospective study. Patients with negative chest x-ray, malignancies or immunosuppression or frequent readmissions were excluded. We collected data on patient characteristics, empirical antibiotic prescribing, treatment duration and clinical outcomes from electronic patient records and the hospital administrative system. We used directed acyclic graphs for statistical model selection, and analysed data with mulitvariable logistic and linear regression. Results We included 651 patients. Median age was 77 years [IQR; 64–84] and 46.5% were female. Median LOS was 4 days [IQR; 3–6], 30-day readmission rate was 14.4% and 30-day mortality rate was 6.9%. Penicillin G/V were empirically prescribed in monotherapy in 51.5% of patients, penicillin G and gentamicin in combination in 22.9% and other antibiotics in 25.6% of patients. Prescribing other antibiotics than penicillin G/V monotherapy was associated with increased risk of readmission [OR 1.9, 95% CI; 1.08–3.42]. Empirical antibiotic prescribing was not associated with LOS. Median intravenous- and total treatment duration was 3.0 [IQR; 2–5] and 11.0 [IQR; 9.8–13] days. Conclusions Our findings show that empirical prescribing with penicillin G/V in monotherapy in hospitalised non-severe CAP-patients, without complicating factors such as malignancy, immunosuppression and frequent readmission, is associated with lower risk of 30-day readmission ... |
format |
Article in Journal/Newspaper |
author |
June Utnes Høgli Beate Hennie Garcia Kristian Svendsen Vegard Skogen Lars Småbrekke |
author_facet |
June Utnes Høgli Beate Hennie Garcia Kristian Svendsen Vegard Skogen Lars Småbrekke |
author_sort |
June Utnes Høgli |
title |
Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study |
title_short |
Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study |
title_full |
Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study |
title_fullStr |
Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study |
title_full_unstemmed |
Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study |
title_sort |
empirical prescribing of penicillin g/v reduces risk of readmission of hospitalized patients with community-acquired pneumonia in norway: a retrospective observational study |
publisher |
BMC |
publishDate |
2020 |
url |
https://doi.org/10.1186/s12890-020-01188-6 https://doaj.org/article/9b37cfc2843448a291a43ec794ca2a38 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
North Norway |
genre_facet |
North Norway |
op_source |
BMC Pulmonary Medicine, Vol 20, Iss 1, Pp 1-9 (2020) |
op_relation |
http://link.springer.com/article/10.1186/s12890-020-01188-6 https://doaj.org/toc/1471-2466 doi:10.1186/s12890-020-01188-6 1471-2466 https://doaj.org/article/9b37cfc2843448a291a43ec794ca2a38 |
op_doi |
https://doi.org/10.1186/s12890-020-01188-6 |
container_title |
BMC Pulmonary Medicine |
container_volume |
20 |
container_issue |
1 |
_version_ |
1766140179473498112 |