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Not All Suspected Pneumonia Cases Require Antibiotics

Small study questions guidelines that all such patients receive antibiotics within four hours

FRIDAY, July 14 (HealthDay News) -- Because of performance measures set by the U.S. Centers for Medicare & Medicaid Services and other organizations, some patients hospitalized with suspected pneumonia may receive unnecessary antibiotic treatment, according to a study in the July issue of Chest.

Mark Metersky, M.D., of the University of Connecticut School of Medicine in Farmington, and colleagues reviewed the hospital charts of 86 Medicare patients who had a discharge diagnosis of pneumonia. Their goal was to determine if there was a potential reason to delay antibiotics other than performance measures, which specify that patients hospitalized with pneumonia receive antibiotics within four hours of presentation.

The researchers found that 19 patients (22 percent) presented in an atypical manner that had the potential to result in delayed antibiotic treatment due to diagnostic uncertainty. Of these patients, 13 (68.4 percent) received antibiotic treatment within four hours of presentation. They found that diagnostic uncertainty was significantly associated with the lack of rales, normal pulse oximetry findings, and lack of an infiltrate seen on the chest radiograph.

"These results suggest that the performance target for the timing of antibiotic administration be set at an appropriate, evidence-based level," the authors conclude.

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