Sammanfattning
BACKGROUND: The Norwegian Directorate of Health publishes national guidelines on antibiotic use in hospitals. In cases of community-acquired pneumonia, penicillin is recommended for mild to moderate pneumonia and penicillin in combination with gentamicin for severe pneumonia. Severity is assessed using the CRB-65 criteria. Little is known about compliance with the guidelines.
METHOD: We examined the medical records of patients admitted to the Department of Infectious Diseases at Oslo University Hospital, Ullevål, with pneumonia caused by Streptococcus pneumoniae or Haemophilus influenza, in 2015 (N = 70), to determine whether the treatment given was in accordance with the national guidelines.
RESULTS: Twenty-four (34 %) patients received penicillin as monotherapy, 25 (36 %) received penicillin and gentamicin in combination, 14 (20 %) received cephalosporins, while 7 (10 %) received other antibiotics. In total, 38 (54 %) patients received empirical antibiotics in accordance with the guidelines. CRB-65 criteria were not recorded for any of the patients. Of the 50 patients treated with penicillin, 38 received a higher dose than recommended. Sixty-two (89 %) patients had their treatment adjusted once the results of microbiological testing were available. The median duration of antibiotic treatment was 10 days (interquartile range 8–11 days).
INTERPRETATION: Broad-spectrum antibiotics were used more often than the guidelines recommend. Treatment was adjusted according to the national guidelines once the results of microbiological testing became available. Penicillin doses and treatment duration often exceeded those recommended by the national guidelines.