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Croatian Medical Journal, Vol. 64 No. 1, 2023.

Original scientific paper

https://doi.org/10.3325/cmj.2023.64.45

Outpatient treatment of pneumonia in a setting with and without an infectious disease doctor

Marija Kusulja ; Dr Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, Croatia *
Maša Žarković ; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
Nikola Kudoić ; Dr Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, Croatia
Monika Mudrovčić ; Dr Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, Croatia
Natalija Sovina Stražičić ; Zagreb University Hospital Center, Zagreb, Croatia
Ivan Gornik ; Zagreb University Hospital Center, Zagreb, Croatia
Vladimir Krajinović ; Dr Fran Mihaljević University Hospital for Infectious Diseases, Zagreb, Croatia

* Corresponding author.

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Abstract

Aim To compare the outpatient treatment of community
acquired pneumonia (CAP) by infectious disease doctors
(IDDs) and doctors of other specialties (nIDDs).
Methods We retrospectively identified 600 outpatients
with CAP: 300 treated by IDDs and 300 by nIDDs in two
tertiary hospitals during 2019. The two groups were compared in terms of adherence to guidelines, antibiotic group
prescription, frequency of combined treatment, and treatment duration.
Results IDDs prescribed significantly more first-line treatment (P<0.001) and alternative treatment (P=0.008).
NIDDs prescribed more reasonable (P<0.001) and unnecessary (P=0.002) second-line treatment, and inadequate
treatment (P=0.004). IDDs significantly more frequently
prescribed amoxicillin (P<0.001) for typical and doxycycline (P=0.045) for atypical CAP, while nIDDs significantly more frequently prescribed amoxicillin-clavulanate
(P<0.001) for typical and fluoroquinolones for both typical
(P<0.001) and atypical (P<0.001) CAP. No significant differences were found in the frequency of combined treatment, which exceeded 50% in both groups, or in treatment duration.
Conclusions Outpatient treatment of CAP in the absence
of IDDs meant more broad-spectrum antibiotic prescription and more disregard for national guidelines. Our results
highlight the need for antibiotic stewardship, especially in
settings with no IDDs.

Keywords

Hrčak ID:

331251

URI

https://hrcak.srce.hr/331251

Publication date:

1.3.2023.

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