Guidelines adherence for patients with community acquired pneumonia in a Greek hospital.

Background And Objectives: Community acquired pneumonia (CAP) remains an important cause of morbidity and mortality, with significant economical and social cost. Adherence to the international guidelines for the empiric treatment of CAP can improve patients' prognosis, reduces the need and shortens the length for hospitalization. However, adherence to guidelines varies among physicians.

Material And Methods: We performed a prospective observational study in 252 immunocompetent hospitalized patients so as to investigate whether the 2003 Infectious Diseases Society of America update of practice guidelines and the Greek national guidelines for CAP are followed by chest physicians working in "Sotiria" General Hospital in Athens, Greece.

Results: Total mortality rate was 12.3%. One hundred twenty (48%) patients were admitted to the Hospital, despite the fact that they were classified as risk class I or II according to the Fine criteria. Accordance to CAP guidelines, as far as the initial antibiotic regimen is concerned, was found to be poor (152 patients, 60%). A trend towards a shorter length of hospitalization was observed in patients treated with an initial antibiotic regimen in accordance to guidelines compared to those receiving an initial antibiotic regimen in discordance to guidelines.

Discussion: The implementation of CAP guidelines by chest physicians working in a Greek Hospital for Thoracic Diseases is poor. Improvement of adherence to guidelines may shorten the length of hospitalization and reduce the financial burden for the National Health System.