Analysis of antibiotic prescriptions in patients with community-acquired pneumonia in clinical practice

Abstract

Objective. To analyze new strategies for the treatment of community-acquired pneumonia (CAP) by age and assess treatment efficacy by age category based on real world data. Materials and Methods. A total of 612 patients (medical charts) with CAP treated in 3 hospitals during the 2017–2019 were included in the retrospective pharmacoepidemiological study. A retrospective analysis of antimicrobial therapy (AMT) administration in the treatment of CAP was performed. Results. Duration of hospital stay in CAP patients of young age was 10% shorter than in patients of any other age category. The least frequency (19.6%) of antibiotic combination administration as initial empiric therapy was found in patients of young age. There were no significant differences in frequency of initial AMT administration between age groups. Ceftriaxone, cefepime and cefoperazone were the most common antimicrobials used as monotherapy in all age groups. Ceftriaxone with azithromycin combination was the most common (42%) initial combination therapy in all age groups. The highest number (27) of various antibiotic combinations was administered to old patients, and the lowest number (16) – to young patients. Efficacy of initial AMT was similar between elderly and old patients. Overall efficacy of initial AMT in patients with non-severe CAP and severe CAP was 54% and 50%, respectively. Analysis of antimicrobial treatment of CAP in real practice and its compliance with the current clinical guidelines showed cephalosporin plus macrolide to be a predominant antibiotic combination (83%). Conclusions. Antibiotic combination administration was found to be common in patients with non-severe CAP, whereas initial monotherapy was administered to severe CAP patients. Antibiotic prescription pattern in patient of young age was different from that in any other age groups. CAP had a less severe course in young patients as evidenced by shorter duration of hospital stay, more frequent monotherapy administration and higher efficacy of initial AMT compared to other age categories. There were no prescriptions of the recommended fifth generation cephalosporin (ceftaroline fosamil).