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Revista Médica de Risaralda

Print version ISSN 0122-0667

Abstract

MACHADO-ALBA, Jorge Enrique et al. Adherence to the practice guideline of community acquired pneumonia in the Hospital Universitario San Jorge, Pereira, Colombia. Revista médica Risaralda [online]. 2012, vol.18, n.2, pp.134-139. ISSN 0122-0667.

Objetive: To determine the variables associated with nonadherence to practice guideline of Community Acquired Pneumonia CAP in the Hospital Universitario San Jorge of Pereira (HUSJ). Methods: Cross-sectional study of all patients over 18 years of either sex with a diagnosis of NAC between January 1, 2010 and March 30, 2012. The information was taken from the medical records considering socio-demographic, clinical (diagnosis, symptoms, comorbidities), paraclinical (leukogram, X-ray, blood cultures) and therapeutic variables (time of hospitalization and medication costs). Adherence was determined according to the fulfillment of this guide. X2 tests and logistic regression were applied.. Results: We found 297 cases of NAC, with slight male predominance (159 men vs 138 women) and mean age 56.3±22.4 years. Adherence to the practice guideline was 14.1% of cases. The antibiotics used were Ampicillin + Sulbactam in 180 patients (60.6% of cases), Ceftriaxone in 53 (17.8%) and Clarithromycin in 31 (10.4%). Blood cultures were 92 and 8.6% reportedgrampositive cocci. The low cost of hospitalization (p=0,03, OR:2,07; 95%CI: 1,02-4,14) and chest X-ray report (p<0.001, OR:16.7; 95%CI:2.26-124.11) was statistically significantly associated with adherence to the guide. Non-adherence was associated with lack of guidance from physicians. Discussion: The HUSJ should update your practice guideline and socialize NAC care among physicians and follow up the implementation to reduce hospital stay, complications and costs.

Keywords : pneumonia; practice guideline; Guideline Adherence; Anti-Infective Agents; Colombia.

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