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http://scihub22266oqcxt.onion/10.1111/j.1553-2712.2012.01342.x
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  • National study of antibiotic use in emergency department visits for pneumonia, 1993 through 2008 #MMPMID22594360
  • Neuman MI; Ting SA; Meydani A; Mansbach JM; Camargo CA Jr
  • Acad Emerg Med 2012[May]; 19 (5): 562-8 PMID22594360garesp_yesshow ga
  • OBJECTIVES: The Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) developed guidelines for the management of community-acquired pneumonia (CAP); however, there are sparse data on actual rates of antibiotic use in the emergency department (ED) setting. METHODS: Data were obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for ED visits during 1993 through 2008 for adults with a diagnosis of pneumonia. RESULTS: During the study period there were an estimated 23,252,000 pneumonia visits, representing 1.8% of all ED visits. The visit rate for pneumonia during this 16-year period may have increased (p trend = 0.055). Overall, 66% of adult patients with a primary diagnosis of pneumonia had documentation of an antibiotic administered while in the ED. There was an increase in antibiotic administration for adults with pneumonia from 1993 through 2008 (49% to 80%; p trend < 0.001). Specifically, there was an increase in use of macrolides from 1993 to 2006 (20% to 30%, p trend < 0.001) and a marked increase in use of quinolones from 0% to 39% from 1993 through 2008 (p trend < 0.001). Penicillin and cephalosporin use remained stable. Use of an antibiotic consistent with 2007 IDSA/ATS guidelines increased from 22% (95% confidence interval [CI] = 16% to 27%) of cases in 1993-1994 to 68% (95% CI = 63% to 73%) of cases in 2007-2008 (p trend < 0.001). CONCLUSIONS: ED visit rates for pneumonia increased slightly from 1993 through 2008. Although antibiotic administration in the ED has increased for adults with CAP, guideline-concordant antibiotics may not be consistently administered.
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Anti-Bacterial Agents/*therapeutic use[MESH]
  • |Community-Acquired Infections/drug therapy[MESH]
  • |Drug Utilization/*statistics & numerical data[MESH]
  • |Emergency Service, Hospital/*statistics & numerical data[MESH]
  • |Female[MESH]
  • |Health Care Surveys[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pneumonia/*drug therapy[MESH]
  • |Retrospective Studies[MESH]
  • |United States/epidemiology[MESH]
  • |Young Adult[MESH]


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