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[Diagnostic methods and treatment of community-acquired pneumonia in Spain: NACE study].

Abstract：

BACKGROUND:Community-acquired pneumonia (CAP) is one of the most frequent infectious disease conditions. With the aim of knowing the diagnostic and therapeutic strategies of CAP in Spanish hospitals we performed a prospective, observational and multicenter study. PATIENTS AND METHOD:Observational study of 468 patients with CAP consecutively evaluated in 21 Spanish hospitals. Clinical, diagnostic, therapeutic and evolutive variables were recorded. RESULTS:We included 468 patients with a mean age of 63 (18) years; 75% of them had some comorbidity. 380 (81%) patients required hospitalization in a conventional ward while 19 (4%) were admitted in an Intensive Care Unit (ICU). 69 patients (15%) required ICU admission. During the first 24 h of admission, biochemical determinations were performed in 98% of cases, blood gas measurements in 88%, blood cultures in 265 (58%), sputum cultures in 149 (41%) and an invasive diagnostic technique was carried out in 17 cases. In 62 cases (14%), a microbiological diagnosis was achieved. Streptococcus pneumoniae (28 cases) was the most frequent isolate followed by Legionella pneumophila (6 cases). Clarithromycin was the most frequent antibiotic prescribed (38%), either as monotherapy (28) or in combination (148), followed by amoxicillin-clavulanate (124 cases). Nine percent of patients were considered non-responders to initial empirical antibiotic tretament. Overall mortality was 6% (25%) and it was significanty higher in non-responders. CONCLUSIONS:In most patients with CAP admitted in Spanish hospitals, a systematic diagnostic approach is lacking. There is an important variability in the administration of antimicrobials, the association of a betalactam plus clarithromycin being the most frequent strategy. Overall mortality is low and significantly higher in those patients with a lack of response to initial antibiotic treatment.

journal_name

Med Clin (Barc)

journal_title

Medicina clinica

authors

Celis MR,Torres A,Zalacaín R,Aspa J,Blanquer J,Blanquer R,Gallardo J,España PP,Grupo de trabajo del Area TIR para el estudio del diagnóstico y tratamiento de la NAC en España (NACE).

doi

10.1016/s0025-7753(02)73405-2

keywords:

subject

Has Abstract

pub_date

2002-09-21 00:00:00

pages

321-6

issue

eissn

0025-7753

issn

1578-8989

pii

S0025-7753(02)73405-2

journal_volume

119

pub_type

杂志文章,多中心研究

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[Diagnostic methods and treatment of community-acquired pneumonia in Spain: NACE study].