scholarly journals CAPPRIC Study—Characterization of Community-Acquired Pneumonia in Spanish Adults Managed in Primary Care Settings

2021 ◽  
Vol 9 (3) ◽  
pp. 508
Author(s):  
Jesús Molina ◽  
Amelia González-Gamarra ◽  
Leovigildo Ginel ◽  
Mª Peláez ◽  
Juan Juez ◽  
...  
Keyword(s):  
Primary Care ◽  
Prospective Observational Study ◽  
Community Acquired Pneumonia ◽  
Hospitalization Rate ◽  
Empiric Antibiotic Therapy ◽  
Radiographic Findings ◽  
Primary Care Settings ◽  
Significant Burden ◽  
Empiric Antibiotic

The real burden of community-acquired pneumonia (CAP) in non-hospitalized patients is largely unknown. This is a 3-year prospective, observational study of ambulatory CAP in adults, conducted in 24 Spanish primary care centers between 2016–2019. Sociodemographic and clinical variables of patients with radiographically confirmed CAP were collected. Pneumococcal etiology was assessed using the Binax Now® test. Patients were followed up for 10 ± 3 days. A total of 456 CAP patients were included in the study. Mean age was 56.6 (±17.5) years, 53.5% were female, and 53.9% had ≥1 comorbidity. Average incidence of CAP was 1.2–3.5 cases per 1000 persons per year. Eighteen patients (3.9%) were classified as pneumococcal CAP. Cough was present in 88.1% of patients at diagnosis and fever in 70.8%. Increased pulmonary density (63.3%) and alveolar infiltrates with air bronchogram (16.6%) were the most common radiographic findings. After 14.6 ± 6.0 days (95% CI = 13.9–15.3), 65.4% of patients had recovered. Hospitalization rate was 2.8%. The most frequently prescribed antibiotics were quinolones (58.7%) and β-lactams (31.1%). In conclusion, one-third of CAP patients did not fully recover after two weeks of empiric antibiotic therapy and 2.8% required hospitalization, highlighting the significant burden associated with non-hospitalized CAP in Spain.

scholarly journals Characteristic Factors of Aspiration Pneumonia to Distinguish from Community-Acquired Pneumonia among Oldest-Old Patients in Primary-Care Settings of Japan

Geriatrics ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. 42 ◽  
Author(s):  
Toshie Manabe ◽  
Kazuhiko Kotani ◽  
Hiroyuki Teraura ◽  
Kensuke Minami ◽  
Takahide Kohro ◽  
...  
Keyword(s):  
Primary Care ◽  
Nursing Home ◽  
Aspiration Pneumonia ◽  
Oldest Old ◽  
Community Acquired Pneumonia ◽  
The Body ◽  
Stepwise Logistic Regression ◽  
Old Patients ◽  
Old Adults ◽  
Primary Care Settings

Background: Aspiration pneumonia (AsP), a phenotype of community-acquired pneumonia (CAP), is a common and problematic disease with symptomless recurrence and fatality in old adults. Characteristic factors for distinguishing AsP from CAP need to be determined to manage AsP. No such factorial markers in oldest-old adults, who are often seen in the primary-care settings, have yet been established. Methods: From the database of our Primary Care and General Practice Study, including the general backgrounds, clinical conditions and laboratory findings collected by primary care physicians and general practitioners, the records of 130 patients diagnosed with either AsP (n = 72) or CAP (n = 58) were extracted. Characteristic factors associated with the diagnosis of AsP were statistically compared between AsP and CAP. Results: The patients were older in the AsP group (median 90 years old) than in the CAP group (86 years old). The body temperature, heart rate, and diastolic blood pressure were lower in the patients with AsP than in those with CAP. Witnessed meal dysphagia by families and caregivers was reported only in AsP. Living in a nursing home, comorbidities of cerebral infarction and dementia (as positive factors) and hypertension (as a negative factor) were considered predictive to diagnose AsP in a stepwise logistic regression analysis. Conclusions: Among oldest-old adults in primary-care settings, living in a nursing home and the dysphagia risks are suggested to be characteristic factors for diagnosing AsP. Age and some relevant clinical information may help manage AsP and also be useful for families and caregivers.

Identification and Characterization of Adverse Drug Events in Primary Care

2016 ◽  
Vol 32 (5) ◽  
pp. 518-525 ◽  
Author(s):  
Katy E. Trinkley ◽  
Harrison G. Weed ◽  
Stuart J. Beatty ◽  
Kyle Porter ◽  
Milap C. Nahata
Keyword(s):  
Primary Care ◽  
Prospective Observational Study ◽  
Care Setting ◽  
Adverse Drug Events ◽  
Primary Care Setting ◽  
Life Threatening ◽  
Internal Medicine Clinic ◽  
Identification And Characterization ◽  
Medication Changes

The purpose of this study was to identify and characterize adverse drug events (ADEs) in a primary care setting using an electronic health record (EHR). This prospective, observational study enrolled patients with any medication change who were seen at an outpatient internal medicine clinic. Patients were evaluated for ADEs by EHR review and telephone interview. ADEs were independently assessed for causality, severity, preventability, and ameliorability by a physician and a pharmacist using a grading instrument. There were 1368 unique medication changes for 701 individuals who completed the study (1.95 changes per person). Of the 226 suspected ADEs, 68 (58%) were deemed to be “definite” or “probable” following causality assessment; 21% were preventable and 40% ameliorable. Only 2 ADEs were serious or life-threatening. Compared with prior reports, ADEs in primary care have decreased in frequency and severity, yet the occurrence of preventable and ameliorable ADEs has increased.

Incidence of all-cause adult community-acquired pneumonia in primary care settings in France

2018 ◽  
Vol 48 (6) ◽  
pp. 389-395 ◽  
Author(s):  
H. Partouche ◽  
A. Lepoutre ◽  
C. Buffel du Vaure ◽  
T. Poisson ◽  
L. Toubiana ◽  
...  
Keyword(s):  
Primary Care ◽  
Community Acquired Pneumonia ◽  
Primary Care Settings

scholarly journals Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population

2021 ◽  
Author(s):  
Riccardo Inchingolo ◽  
Roberto Copetti ◽  
Andrea Smargiassi ◽  
Rafael Emanuele Gerardi ◽  
Emanuele Giovanni Conte ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Community Acquired Pneumonia ◽  
Empiric Antibiotic Therapy ◽  
Non Invasive ◽  
Lung Consolidation ◽  
Therapy Relationship ◽  
Increased Risk ◽  
Empiric Antibiotic ◽  
Registration Number ◽  
Invasive Method

Abstract Aims Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization. Methods Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted. Results Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008). Conclusions USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP. Trial registration number and date of registration NCT03556488, June 14, 2018. Graphic abstract

scholarly journals Best Practice for Prolonged Fever in Primary Care Setting: Close Follow-Up or Empiric Antibiotic Therapy?

2018 ◽  
Vol 39 (5) ◽  
pp. 318-321
Author(s):  
Mahnaz Sandoughi ◽  
Seyed Amirhossein Fazeli ◽  
Fatemeh Naseri-Ramroudi ◽  
Farzaneh Barzkar
Keyword(s):  
Primary Care ◽  
Antibiotic Therapy ◽  
Best Practice ◽  
Care Setting ◽  
Primary Care Setting ◽  
Empiric Antibiotic Therapy ◽  
Prolonged Fever ◽  
Empiric Antibiotic
Sign in / Sign up

Export Citation Format

Share Document