Measuring the prevalence of aspiration pneumonia in view of improving the relevance of antibiotic prescription of antibiotics: A retrospective, observational study - 17/04/24
Highlights |
• | Aspiration pneumonia is over-diagnosed with a high impact on antibiotic prescription. |
• | Only 5% of aspiration pneumonia cases are certain or likely. |
• | Consequently, from 17 to 46% of antibiotic therapy could have been avoided. |
• | And at least one third of the antibiotic spectrum is needlessly and excessively broad. |
Abstract |
Purpose |
Aspiration pneumonia (AP) has significant incidence and impact on mortality. However, data about clinical diagnosis criteria are scarce. We aimed to evaluate according to predefined criteria the prevalence of true AP and its impact on antibiotic stewardship.
Methods |
Retrospective study of patients whose main diagnosis was AP hospitalized at Amiens University Hospital in 2018. We first defined diagnostic criteria of certainty for pneumonia and aspiration. AP was then classified according to degree of certainty.
Results |
Among 862 cases of AP, its diagnosis was certain, likely, probably in excess, certainly in excess or absent in 2 % (n = 17), 3 % (n = 26), 50.5 % (n = 433), 23.1 % (n = 198) and 21.4 % (n = 183) respectively. Irrelevant use of amoxicillin-clavulanic acid and metronidazole was found in 27 % and 13 % of cases, respectively.
Conclusions |
The diagnosis of AP is frequently excessive, and diagnostic tools are urgently needed to improve antibiotic stewardship.
Le texte complet de cet article est disponible en PDF.Keywords : Aspiration pneumonia, Diagnosis, Treatment, Antibiotic therapy
Plan
Vol 54 - N° 3
Article 104885- avril 2024 Retour au numéro
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