The effect of taking antibacterial therapy on the outpatient stage and outcomes of community-acquired pneumonia in Tomsk hospitals

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Abstract

Background. Community-acquired pneumonia (CAP) remains one of the most common diseases requiring urgent hospitalization, with a significant part of patients already receiving antibiotics before admission to the hospital.

Aim. To assess the relationship between outpatient antibacterial therapy and in-hospital mortality and the severity of the CAP.

Materials and methods. The retrospective study included the data of adult patients with CAP who were hospitalized in Tomsk from January 1 to December 31, 2017.

Results. Among 1412 patients, 22.2% received antibiotics before admission to the hospital, the proportion of deaths in this group was significantly lower – 3.8% compared with 10.6% among patients without antibiotic therapy (p<0.001). Subjects who received antibiotics on outpatient basis were less likely to require being in the intensive care unit and administering vasopressors, in contrast to patients without prior antibiotic therapy: 5.1 and 10.6% (p=0.003); 7.1 and 4.7% (p=0.018) respectively. In patients with severe CAP on a scale IDSA/ATS, only 11.8% of cases were detected with antibiotics before hospitalization, while in mild CAP the frequency of administration was 16.6% (p<0.001).

Conclusion. Ambulatory antibacterial therapy had a positive effect on the subsequent course and outcomes of CAP in a hospital setting. Patients had a predominantly mild course of the disease, needing for vasopressors, and being in the intensive care unit, but was not consistent with the need for invasive mechanical ventilation.

About the authors

Daria A. Vinokurova

Siberian State Medical University

Email: elena-starovoytova@yandex.ru
ORCID iD: 0000-0002-8422-8349

зав. факультетской терапевтической клиникой

Russian Federation, Tomsk

Evgeny S. Kulikov

Siberian State Medical University

Email: evgeny.s.kulikov@gmail.com
ORCID iD: 0000-0002-0088-9204

доктор медицинских наук, ректор

Russian Federation, Tomsk

Olga S. Kobyakova

Russian Research Institute of Health

Email: o.s.kobyakova@gmail.com
ORCID iD: 0000-0003-0098-1403

доктор медицинских наук, профессор, директор

Russian Federation, Moscow

Elena A. Starovoytova

Siberian State Medical University

Author for correspondence.
Email: elena-starovoytova@yandex.ru
ORCID iD: 0000-0002-4281-1157

Head of the Department of General Medical Practice and Outpatient Therapy

Russian Federation, Tomsk

Ivan A. Deev

Russian Research Institute of Health

Email: deevia@mednet.ru
ORCID iD: 0000-0002-4449-4810

доктор медицинских наук, профессор, зам. директора по организации здравоохранения

Russian Federation, Moscow

Sergey V. Fedosenko

Siberian State Medical University

Email: sergey.fedosenko@icloud.com
ORCID iD: 0000-0001-6655-3300

доктор медицинских наук, доцент, профессор кафедры общей врачебной практики и поликлинической терапии

Russian Federation, Tomsk

Georgy E. Chernogoryuk

Siberian State Medical University

Email: chernogoryuk@yandex.ru
ORCID iD: 0000-0001-5780-6660

доктор медицинских наук, профессор кафедры госпитальной терапии с курсом реабилитации, физиотерапии и спортивной медицины

Russian Federation, Tomsk

Ekaterina A. Chernysheva

Medical and Sanitary Unit №2

Email: cherniisheva69@gmail.com
ORCID iD: 0000-0002-0553-4410

врач

Russian Federation, Tomsk

Nikolay D. Yarovoy

Tomsk Regional Oncology Center

Email: koly-yarovoy@yandex.ru
ORCID iD: 0000-0003-3619-6095

врач

Russian Federation, Tomsk

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