Initiating antibiotic therapy in the emergency department decreases length of stay for patients with the diagnosis of community-acquired pneumonia

1999 ◽  
Vol 34 (4) ◽  
pp. S28 ◽  
Author(s):  
J Balentine ◽  
D Battleman ◽  
M Callahan
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Antibiotic Therapy ◽  
Community Acquired Pneumonia

scholarly journals Antimicrobial switch therapy in pediatric patients hospitalized by uncomplicated community-acquired pneumonia

2020 ◽  
Vol 11 (3) ◽  
pp. 482
Author(s):  
Ronaldo MORALES-JUNIOR ◽  
Anna C. BARRIENTOS ◽  
Raquel M. SCALCO ◽  
Aline G. FEVEREIRO ◽  
Sulim ABRAMOVICI ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Antibiotic Therapy ◽  
Length Of Hospital Stay ◽  
Venous Access ◽  
Cross Sectional Study ◽  
Community Acquired Pneumonia ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Switch Therapy ◽  
Severe Community Acquired Pneumonia

Objective: To evaluate the duration of intravenous (IV) antibiotic therapy and the practice of switch therapy to oral in the treatment of children aged 2 months to 5 years with uncomplicated severe community acquired pneumonia (CAP) in a pediatric public hospital. Methods: Retrospective, observational and cross-sectional study in which patients who started IV ampicillin treatment were selected. The patients were classified as “eligible” or “ineligible” to undergo switch therapy after 48 and 72 hours of hospitalization according to clinical criteria. Patients with length of stay <or ≥7 days were compared regarding demographic characteristics and antibiotic therapy, considering p <0.05 significant. Results: Eighty-six patients were evaluated, aged 14.4 (IQR: 10.8-22.7) months. The duration of IV therapy was 4 (IQR: 3-6) days; 56% of patients were classified as eligible for switch therapy within 48h and 74% as eligible within 72h. However, only 19 cases (22%) underwent switch therapy at the appropriate time. The main reason for the transition was the accidental loss of venous access (61%). The group with length of stay <7 days had a higher rate of switch and, consequently, shorter IV therapy duration (p <0.01). Conclusion: The switch therapy in the first 48 to 72 hours is not routinely used in the clinical practice in patients hospitalized with CAP. The findings warn of the need for institutional initiatives on this practice, aiming at improving the quality of care with shorter IV therapy duration and impact on length of hospital stay.

scholarly journals Impact of Procalcitonin Guidance on the Management of Adults Hospitalized with Pneumonia

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S17-S17
Author(s):  
Thomas Walsh ◽  
Briana DiSilvio ◽  
Crystal Hammer ◽  
Moeezullah Beg ◽  
Swati Vishwanathan ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Antibiotic Therapy ◽  
Real World ◽  
Antibiotic Use ◽  
Hospital Length ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Teaching Hospitals ◽  
Post Intervention ◽  
Duration Of Therapy

Abstract Background Community-acquired pneumonia and healthcare-associated pneumonia are often treated with prolonged antibiotic therapy. Procalcitonin (PCT) has effectively and safely reduced antibiotic use for pneumonia in controlled studies. However, limited data exist regarding PCT guidance in real-world settings for management of pneumonia. Methods A retrospective, preintervention/postintervention quality improvement study was conducted to compare management for patients admitted with pneumonia before and after implementation of PCT guidance at two teaching hospitals in Pittsburgh, Pennsylvania. The preintervention period was March 1, 2014 through October 31, 2014, and the post-intervention period was March, 1 2015 through October 31, 2015. Results A total of 152 and 232 patients were included in the preintervention and postintervention cohorts, respectively. When compared with the preintervention group, the mean duration of therapy decreased (9.9 vs. 6.1 days; P &lt; 0.001). More patients received an appropriate duration of 7 days or less (26.9% vs. 66.4%; P &lt; 0.001). Additionally, mean hospital length of stay decreased in the postintervention group (4.9 vs. 3.5 days; P = 0.006). Pneumonia-related 30-day readmission rates (7.2% vs. 4.3%; P = 0.99) were unaffected. In the postintervention group, patients with PCT levels &lt; 0.25 µg/l received shorter mean duration of therapy compared with patients with levels &gt;0.25 µg/l (8.0 vs. 4.6 days; P &lt; 0.001) as well as reduced hospital length of stay (3.9 vs. 3.2 days; P = 0.02). Conclusion In this real-world practice study, PCT guidance led to shorter durations of total antibiotic therapy and abridged inpatient length of stay without affecting hospital re-admissions. Disclosures All authors: No reported disclosures.

scholarly journals National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Akshay Pendyal ◽  
Craig Rothenberg ◽  
Jean E. Scofi ◽  
Harlan M. Krumholz ◽  
Basmah Safdar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Length Of Stay ◽  
Real World ◽  
The United States ◽  
Emergency Department Care ◽  
Care Processes ◽  
Ed Visits

Background Despite investments to improve quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real‐world trends in AMI care in the emergency department (ED). We aimed to describe trends in the epidemiology and quality of AMI care in US EDs over a recent 11‐year period, from 2005 to 2015. Methods and Results We conducted an observational study of ED visits for AMI using the National Hospital Ambulatory Medical Care Survey, a nationally representative probability sample of US EDs. AMI visits were classified as ST‐segment–elevation myocardial infarction (STEMI) and non‐STEMI. Outcomes included annual incidence of AMI, median ED length of stay, ED disposition type, and ED administration of evidence‐based medications. Annual ED visits for AMI decreased from 1 493 145 in 2005 to 581 924 in 2015. Estimated yearly incidence of ED visits for STEMI decreased from 1 402 768 to 315 813. The proportion of STEMI sent for immediate, same‐hospital catheterization increased from 12% to 37%. Among patients with STEMI sent directly for catheterization, median ED length of stay decreased from 62 to 37 minutes. ED administration of antithrombotic and nonaspirin antiplatelet agents rose for STEMI (23%–31% and 10%–27%, respectively). Conclusions National, real‐world trends in the epidemiology of AMI in the ED parallel those of clinical registries, with decreases in AMI incidence and STEMI proportion. ED care processes for STEMI mirror evolving guidelines that favor high‐intensity antiplatelet therapy, early invasive strategies, and regionalization of care.

Sign in / Sign up

Export Citation Format

Share Document