CH4 Implementation of pneumonia clinical pathway. (Chest Diseases).

CH4 IMPLEMENTATION OF PNEUMONIA CLINICAL PATHWAY Darryl L. Jordan, MD, and Mitzi Wiseman, RN. Department of Internal Medicine, Meharry Medical College, Nashville, Tenn.

The mortality rate for community-acquired pneumonia (CAP) ranges from 1% to 25% in hospitalized patients. The Infectious Disease Society of America's guidelines are useful for treatment of patients with CAP. This study was designed to determine the efficiency of IDSA practice guideline implementation in an academic setting. IDSA recommendations were used in 20 patients with CAP. Patients were categorized and started on antibiotics. Patient demographics: average age-53,2 years; sex-male (71%), female (19%); race-black (57.1%), white (29.0%), Hispanic (9.5%), other (4.8%); tobacco use-smokers (58.8%) nonsmokers (41.0%); white blood cell count, mean 10.8 [micro]1/mL; antibiotic selection-levafloxacin alone 10%, levafloxacin + antibiotic 55%; Ceftriaxone alone 5%, Ceftriaxone + antibiotic 60%; length of stay-6.7 days; mortality-5.0%. Patients in the study were given a [beta]-lactam or fluoroquinolone in combination with other antibiotics. The scoring index was recorded in 3 patients. This suggests that greater em phasis should be placed on adequately implementing guidelines in academic settings.