{"id":13157,"date":"2023-01-04T00:00:00","date_gmt":"2023-01-04T05:00:00","guid":{"rendered":""},"modified":"2023-11-22T15:22:49","modified_gmt":"2023-11-22T20:22:49","slug":"guideline-concordant-antibiotic-therapy-for-the-hospital-treatment-of-community-acquired-pneumonia-and-1-year-all-cause-and-cardiovascular-mortality-in-elderly-patients-surviving-to-discharge","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/guideline-concordant-antibiotic-therapy-for-the-hospital-treatment-of-community-acquired-pneumonia-and-1-year-all-cause-and-cardiovascular-mortality-in-elderly-patients-surviving-to-discharge\/","title":{"rendered":"Guideline-concordant antibiotic therapy for the hospital treatment of community-acquired pneumonia and 1-year all-cause and cardiovascular mortality in elderly patients surviving to discharge"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Selection of empiric antibiotic treatment for community-acquired pneumonia (CAP) that is concordant with clinical practice guidelines has been associated with improved short-term outcomes of this infection, but whether it is also associated with longer-term outcomes is unknown.<\/p>\n<p><strong>Research Question<\/strong> \u2014 Is guideline-concordance of the initial antibiotic treatment given to elderly patients hospitalized with CAP associated with the 1-year all-cause and cardiovascular mortality risk of those patients that survive hospitalization for this infection?<\/p>\n<p><strong><span class=\"bold\">Study Design and Methods<\/span><\/strong> \u2014 We identified 1909 elderly (&gt;65 years of age) patients that survived hospitalization for CAP at The Ottawa Hospital in Ontario, Canada between 2004 and 2015. Linking patients\u2019 information to hospital and provincial datasets, we analyzed whether the selection of the initial antibiotic therapy for their CAP was concordant with current clinical practice guidelines, and whether guideline-concordance was associated with 1-year all-cause and cardiovascular mortality after their index CAP hospitalization while adjusting for their overall 1-year expected death risk, CAP severity, and history of previous pneumonia admissions, myocardial infarction, heart failure or cerebrovascular disease.<\/p>\n<p><strong>Results<\/strong> \u2014 Selection of guideline-concordant antibiotic therapy was associated with a trend towards lower all-cause mortality at 1-year post-CAP (hazard ratio [HR] 0.82, 95%CI 0.65-1.04, p=0.099). Furthermore, the use of guideline-concordant antibiotic therapy was associated with a significant almost 50% reduction in cardiovascular death risk 1 year after CAP admission (HR 0.53, 95%CI 0.34-0.80, p=0.003).<\/p>\n<p><strong>Interpretation<\/strong> \u2014 Use of guideline-concordant antibiotic therapy for CAP treatment in elderly hospitalized patients is associated with a significant reduction in the risk of cardiovascular death at 1-year post-CAP. This finding further supports current clinical practice guideline recommendations for CAP treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Selection of empiric antibiotic treatment for community-acquired pneumonia (CAP) that is concordant with clinical practice guidelines has been associated with improved short-term outcomes of this infection, but whether it is also associated with longer-term outcomes is unknown. Research Question \u2014 Is guideline-concordance of the initial antibiotic treatment given to elderly patients hospitalized with [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[39,17],"migration-helper-qa-sample-set":[],"class_list":["post-13157","journal_article","type-journal_article","status-publish","hentry","topic-infectious-diseases","topic-older-people"],"acf":{"citation":"Corrales-Medina VF, van Walraven C. <em>Chest<\/em>. 2023; 163(6):1380-9. Epub 2023 Jan 4.","source_url":"https:\/\/doi.org\/10.1016\/j.chest.2022.12.035","ices_scientist":[1119],"site":[6734],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"01E18FBF-2478-4F4C-BA97-33E985504DB7","sitecore_item_name":"Guideline-concordant-antibiotic-therapy-for-the-hospital-treatment-of-community-acquired-pneumonia","sitecore_field_values":"{\r\n  \"Title\": \"Guideline-concordant antibiotic therapy for the hospital treatment of community-acquired pneumonia and 1-year all-cause and cardiovascular mortality in elderly patients surviving to discharge\",\r\n  \"Short title\": \"Guideline-concordant antibiotic therapy\",\r\n  \"Summary\": \"The study findings further supports current clinical practice guideline recommendations for community-acquired pneumonia treatment.\",\r\n  \"Citation\": \"<p>Corrales-Medina VF, van Walraven C. <em>Chest<\/em>. 2023; Jan 4 [Epub ahead of print]. DOI: <a href=\"https:\/\/doi.org\/10.1016\/j.chest.2022.12.035\" title=\"opens external link\">https:\/\/doi.org\/10.1016\/j.chest.2022.12.035<\/a><\/p>\",\r\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Selection of empiric antibiotic treatment for community-acquired pneumonia (CAP) that is concordant with clinical practice guidelines has been associated with improved short-term outcomes of this infection, but whether it is also associated with longer-term outcomes is unknown.<\/p>n<p><strong>Research Question<\/strong> &mdash; Is guideline-concordance of the initial antibiotic treatment given to elderly patients hospitalized with CAP associated with the 1-year all-cause and cardiovascular mortality risk of those patients that survive hospitalization for this infection?<\/p>n<p><span class=\"bold\">Study Design and Methods<\/span> &mdash; We identified 1909 elderly (&gt;65 years of age) patients that survived hospitalization for CAP at The Ottawa Hospital in Ontario, Canada between 2004 and 2015. Linking patients&rsquo; information to hospital and provincial datasets, we analyzed whether the selection of the initial antibiotic therapy for their CAP was concordant with current clinical practice guidelines, and whether guideline-concordance was associated with 1-year all-cause and cardiovascular mortality after their index CAP hospitalization while adjusting for their overall 1-year expected death risk, CAP severity, and history of previous pneumonia admissions, myocardial infarction, heart failure or cerebrovascular disease.<\/p>n<p><strong>Results<\/strong> &mdash; Selection of guideline-concordant antibiotic therapy was associated with a trend towards lower all-cause mortality at 1-year post-CAP (hazard ratio [HR] 0.82, 95%CI 0.65-1.04, p=0.099). Furthermore, the use of guideline-concordant antibiotic therapy was associated with a significant almost 50% reduction in cardiovascular death risk 1 year after CAP admission (HR 0.53, 95%CI 0.34-0.80, p=0.003).<\/p>n<p><strong>Interpretation<\/strong> &mdash; Use of guideline-concordant antibiotic therapy for CAP treatment in elderly hospitalized patients is associated with a significant reduction in the risk of cardiovascular death at 1-year post-CAP. This finding further supports current clinical practice guideline recommendations for CAP treatment.<\/p>\",\r\n  \"Posted Date\": \"20230104T000000\",\r\n  \"Show on Publications Landing Page\": \"1\"\r\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2023\/January\/Guideline-concordant-antibiotic-therapy-for-the-hospital-treatment-of-community-acquired-pneumonia"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Guideline-concordant antibiotic therapy for the hospital treatment of community-acquired pneumonia and 1-year all-cause and cardiovascular mortality in elderly patients surviving to discharge<\/title>\n<meta name=\"description\" content=\"Background \u2014 Selection of empiric antibiotic treatment for community-acquired pneumonia (CAP) that is concordant with clinical practice guidelines has\" \/>\n<meta name=\"robots\" content=\"index, follow, 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