Article Sidebar
Published:
Sep 19, 2007Article Details
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.
Main Article Content
Poor adherence to South African guidelines for the management of community-acquired pneumonia
Abstract
Objective. To evaluate adherence to the South African guidelines
for the management of community-acquired pneumonia
(CAP) and to determine whether adherence reduced length of
hospital stay and mortality in patients with severe CAP.
Setting. King Edward VIII Hospital, Durban.
Methods. Four hundred and thirty patients with CAP were
recruited between June 2000 and October 2001. Severity
assessment data were collected. Severe CAP was defined by the
presence of two or more markers. Without influence from the
investigators, the admitting team chose the empirical antibiotic
regimen. Antibiotics administered, outcome and length of stay
were analysed.
Results. Two hundred and eighty-seven of 430 patients were
eligible for analysis. One hundred and eighty-two patients
had two or more markers of severe CAP. Fourteen of the
182 patients (8%) had initial antibiotic therapy administered
according to South African guidelines and 168 (92%) did not.
The mortality rate was 20% (36 patients). Accounting for
sample size there was no statistically significant difference
in length of stay between the two groups (14 v. 12 days, p =
1.0000, odds ratio (OR) 1.167, 95% confidence interval (CI):
0.3926 - 3.467) or in mortality rate (28.5% v. 19%, p = 0.3549, OR
1.667, 95% CI: 0.667 - 4.161).
Conclusion. There was very poor adherence with South African
CAP antibiotic guidelines. The sample size of patients receiving
treatment according to the South African Thoracic Society
(SATS) guidelines was too low to confirm confidently that
adherence may have resulted in a clinical benefit.
South African Medical Journal Vol. 97 (8) 2007: pp. 601-603
