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[Questionnaire survey of guideline implementation for community acquired pneumonia with retrospective analysis of the empiric treatment in 490 patients].
Zhonghua Jie He He Hu Xi Za Zhi. 2007 Jun; 30(6):442-6.ZJ

Abstract

OBJECTIVE

To assess physicians' awareness and use of guidelines for community-acquired pneumonia (CAP) published by Chinese Society of Respiratory Diseases (CSRD) and American Thoracic Society (ATS), and to investigate influences of the guidelines on the prognosis of patients with CAP.

METHOD

A total of 210 self-completion questionnaires about CAP guidelines were received from doctors of six hospitals in Beijing. In addition, 490 serial cases of CAP collected from these hospitals admitted from January 2002 to December 2003 were retrospectively analyzed.

RESULTS

Most doctors had limited knowledge about atypical pathogens. For pulmonary physicians, only 46% (97/210) reported using the CSRD guideline. 82.4% of the doctors preferred to give initial empiric antibiotic therapy according to the patients' conditions. 79.5% (167/210) of the doctors ordered examination of the pathogens routinely and 84.3% (177/210) of them admitted its usefulness for choosing antibiotics. 84.5% (414/490) of the patients responded well to the initial empiric treatment. Patients who were treated according to the guidelines of CSRD and ATS were 229 cases and 131 cases respectively. There was no significant difference in the prognosis between patients who were treated according to the guideline and those who were not. There was no significant difference in the prognosis between cases with definite pathogens and cases without.

CONCLUSIONS

The results indicate low levels of awareness and use of guidelines for the management of CAP. Fewer than half of the patients were treated according to the guidelines. However, the treatments were effective in most of the patients, and there was no significant difference in the prognosis between patients who were treated according to the guideline and those who were not, because broad-spectrum antibiotics were overused. More effective guideline implementation strategies are needed to encourage compliance with practice guidelines for the management of CAP.

Authors+Show Affiliations

Xu ZJ
Department of Respiratory Medicine, Peking Union Medical College, Peking Union Medical Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Ding K
No affiliation info available
Huang H
No affiliation info available
Sun TY
No affiliation info available
Ke HX
No affiliation info available
Tong ZH
No affiliation info available
Wei TN
No affiliation info available
Peng K
No affiliation info available
Yao B
No affiliation info available
Li FX
No affiliation info available
Liu JH
No affiliation info available
Chinese Society of Respiratory Diseases
No affiliation info available
American Thoracic Society
No affiliation info available

MeSH

Anti-Bacterial AgentsCommunity-Acquired InfectionsData CollectionFemaleGuideline AdherenceHumansMalePhysiciansPneumonia, BacterialPractice Guidelines as TopicPractice Patterns, Physicians'Retrospective StudiesSurveys and Questionnaires

Pub Type(s)

English Abstract
Journal Article
Research Support, Non-U.S. Gov't

Language

chi

PubMed ID

17673019

Citation

Xu, Zuo-jun, et al. "[Questionnaire Survey of Guideline Implementation for Community Acquired Pneumonia With Retrospective Analysis of the Empiric Treatment in 490 Patients]." Zhonghua Jie He He Hu Xi Za Zhi = Zhonghua Jiehe He Huxi Zazhi = Chinese Journal of Tuberculosis and Respiratory Diseases, vol. 30, no. 6, 2007, pp. 442-6.
Xu ZJ, Ding K, Huang H, et al. [Questionnaire survey of guideline implementation for community acquired pneumonia with retrospective analysis of the empiric treatment in 490 patients]. Zhonghua Jie He He Hu Xi Za Zhi. 2007;30(6):442-6.
Xu, Z. J., Ding, K., Huang, H., Sun, T. Y., Ke, H. X., Tong, Z. H., Wei, T. N., Peng, K., Yao, B., Li, F. X., & Liu, J. H. (2007). [Questionnaire survey of guideline implementation for community acquired pneumonia with retrospective analysis of the empiric treatment in 490 patients]. Zhonghua Jie He He Hu Xi Za Zhi = Zhonghua Jiehe He Huxi Zazhi = Chinese Journal of Tuberculosis and Respiratory Diseases, 30(6), 442-6.
Xu ZJ, et al. [Questionnaire Survey of Guideline Implementation for Community Acquired Pneumonia With Retrospective Analysis of the Empiric Treatment in 490 Patients]. Zhonghua Jie He He Hu Xi Za Zhi. 2007;30(6):442-6. PubMed PMID: 17673019.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Questionnaire survey of guideline implementation for community acquired pneumonia with retrospective analysis of the empiric treatment in 490 patients]. AU - Xu,Zuo-jun, AU - Ding,Ke, AU - Huang,Hui, AU - Sun,Tie-ying, AU - Ke,Hui-xing, AU - Tong,Zhao-hui, AU - Wei,Tian-ni, AU - Peng,Kun, AU - Yao,Bin, AU - Li,Feng-xian, AU - Liu,Jian-hua, AU - ,, AU - ,, PY - 2007/8/4/pubmed PY - 2009/1/27/medline PY - 2007/8/4/entrez SP - 442 EP - 6 JF - Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases JO - Zhonghua Jie He He Hu Xi Za Zhi VL - 30 IS - 6 N2 - OBJECTIVE: To assess physicians' awareness and use of guidelines for community-acquired pneumonia (CAP) published by Chinese Society of Respiratory Diseases (CSRD) and American Thoracic Society (ATS), and to investigate influences of the guidelines on the prognosis of patients with CAP. METHOD: A total of 210 self-completion questionnaires about CAP guidelines were received from doctors of six hospitals in Beijing. In addition, 490 serial cases of CAP collected from these hospitals admitted from January 2002 to December 2003 were retrospectively analyzed. RESULTS: Most doctors had limited knowledge about atypical pathogens. For pulmonary physicians, only 46% (97/210) reported using the CSRD guideline. 82.4% of the doctors preferred to give initial empiric antibiotic therapy according to the patients' conditions. 79.5% (167/210) of the doctors ordered examination of the pathogens routinely and 84.3% (177/210) of them admitted its usefulness for choosing antibiotics. 84.5% (414/490) of the patients responded well to the initial empiric treatment. Patients who were treated according to the guidelines of CSRD and ATS were 229 cases and 131 cases respectively. There was no significant difference in the prognosis between patients who were treated according to the guideline and those who were not. There was no significant difference in the prognosis between cases with definite pathogens and cases without. CONCLUSIONS: The results indicate low levels of awareness and use of guidelines for the management of CAP. Fewer than half of the patients were treated according to the guidelines. However, the treatments were effective in most of the patients, and there was no significant difference in the prognosis between patients who were treated according to the guideline and those who were not, because broad-spectrum antibiotics were overused. More effective guideline implementation strategies are needed to encourage compliance with practice guidelines for the management of CAP. SN - 1001-0939 UR - https://www.unboundmedicine.com/medline/citation/17673019/[Questionnaire_survey_of_guideline_implementation_for_community_acquired_pneumonia_with_retrospective_analysis_of_the_empiric_treatment_in_490_patients]_ DB - PRIME DP - Unbound Medicine ER -