The effect of taking antibacterial therapy on the outpatient stage and outcomes of community-acquired pneumonia in Tomsk hospitals
- Authors: Vinokurova D.A.1, Kulikov E.S.1, Kobyakova O.S.2, Starovoytova E.A.1, Deev I.A.2, Fedosenko S.V.1, Chernogoryuk G.E.1, Chernysheva E.A.3, Yarovoy N.D.4
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Affiliations:
- Siberian State Medical University
- Russian Research Institute of Health
- Medical and Sanitary Unit №2
- Tomsk Regional Oncology Center
- Issue: Vol 96, No 1 (2024)
- Pages: 11-16
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/258636
- DOI: https://doi.org/10.26442/00403660.2024.01.202574
- ID: 258636
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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.
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##article.viewOnOriginalSite##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, TomskEvgeny S. Kulikov
Siberian State Medical University
Email: evgeny.s.kulikov@gmail.com
ORCID iD: 0000-0002-0088-9204
доктор медицинских наук, ректор
Russian Federation, TomskOlga 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, MoscowElena 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, TomskIvan 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, MoscowSergey 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, TomskGeorgy 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, TomskEkaterina A. Chernysheva
Medical and Sanitary Unit №2
Email: cherniisheva69@gmail.com
ORCID iD: 0000-0002-0553-4410
врач
Russian Federation, TomskNikolay D. Yarovoy
Tomsk Regional Oncology Center
Email: koly-yarovoy@yandex.ru
ORCID iD: 0000-0003-3619-6095
врач
Russian Federation, TomskReferences
- 10 ведущих причин смерти в мире. Всемирная организация здравоохранения. Режим доступа: https://www.who.int/ru/news-room/fact-sheets/detail/the-top-10-causes-of-death. Ссылка активна на 01.12.2022 [The top 10 causes of death. World health Organization. Available at: https://www.who.int/ru/news-room/fact-sheets/detail/the-top-10-causes-of-deathAccessed: 01.12.2022 [(in Russian)].
- Инфекционная заболеваемость в Российской Федерации за январь – декабрь 2018 г. Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека. Режим доступа: https://rospotrebnadzor.ru/activities/statistical-materials/statictic_details.php?ELEMENT_ID=11277. Ссылка активна на 15.01.2024 [Infectious morbidity in the Russian Federation for January – December 2018 Federal Service for Supervision of Consumer Rights Protection and Human Well-Being. Available at: https://rospotrebnadzor.ru/activities/statistical-materials/statictic_details.php?ELEMENT_ID=11277. Accessed: 15.01.2024 (in Russian)].
- Bjarnason A, Westin J, Lindh M, et al. Incidence, Etiology, and Outcomes of Community-Acquired Pneumonia: A Population-Based Study. Open Forum Infect Dis. 2018;5(2):ofy010. doi: 10.1093/ofid/ofy010
- Van de Garde EM, Souverein PC, Van den Bosch JM, et al. Prior outpatient antibacterial therapy as prognostic factor for mortality in hospitalized pneumonia patients. Respir Med. 2006;100(8):1342-8. doi: 10.1016/j.rmed.2005.11.024
- Chakrabarti B, Wootton D, Lane S, et al. The association between pre-hospital antibiotic therapy and subsequent in-hospital mortality in adults presenting with community-acquired pneumonia: an observational study. Pneumonia (Nathan). 2018;10:2. doi: 10.1186/s41479-018-0047-4
- Amaro R, Sellarés J, Polverino E, et al. Antibiotic therapy prior to hospital admission is associated with reduced septic shock and need for mechanical ventilation in patients with community-acquired pneumonia. J Infect. 2017;74(5):442-9. doi: 10.1016/j.jinf.2017.01.009
- Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377-82. doi: 10.1136/thorax.58.5.377
- Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44 Suppl. 2:S27-72. doi: 10.1086/511159
- Simonetti AF, Garcia-Vidal C, Viasus D, et al. Declining mortality among hospitalized patients with community-acquired pneumonia. Clin Microbiol Infect. 2016;22(6):567.e1-5677. doi: 10.1016/j.cmi.2016.03.015
- Kolditz M, Bauer TT, König T, et al. 3-day mortality in hospitalised community-acquired pneumonia: frequency and risk factors. Eur Respir J. 2016;47(5):1572-4. doi: 10.1183/13993003.00113-2016
- Simonetti AF, Viasus D, Garcia-Vidal C, et al. Impact of pre-hospital antibiotic use on community-acquired pneumonia. Clin Microbiol Infect. 2014;20(9):O531-7. doi: 10.1111/1469-0691.12524
- Havers FP, Hicks LA, Chung JR, et al. Outpatient Antibiotic Prescribing for Acute Respiratory Infections During Influenza Seasons. JAMA Netw Open. 2018;1(2):e180243. doi: 10.1001/jamanetworkopen.2018.0243