Clinical Trial: Delayed Antibiotic Treatment in Community-acquired Pneumococcal Pneumonia.
Study Status: Completed
Recruit Status: Completed
Study Type: Observational
Official Title: Delayed Antibiotic Treatment in Community-acquired Pneumococcal Pneumonia. Analysis of Risk Factors and Impact on the Outcome.
Brief Summary:
I. To investigate time measurement from emergency room admission to first antibiotic administration.
II. To evaluate risk factors for prolonged time to first antibiotic administration.
III. To correlate time measurement with Charlson comorbidity index and multimorbidity patterns.
IV. To investigate the impact of a delayed time to first antibiotic administration on the outcome
Detailed Summary:
In this retrospective cohort study, we plan to include all patients presenting with a community-acquired pneumococcal pneumonia at the University Hospital of Zurich between January 1, 2006 and June 30, 2012 (6½ years). The patients will be identified either with one or more blood culture pairs positive for S. pneumoniae or with a positive pneumococcal urine antigen assay in combination with the clinical diagnosis of CAP, which was based on the presence of select clinical features (e.g., cough, fever, sputum production, and pleuritic chest pain) and is supported by imaging of the lung, usually by chest radiography according to Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of CAP in adults [11].
CAP is not considered if the patient is discharged from a hospital less than 7 days before the current hospital admission, if the first blood culture or urinary antigen assay is obtained more than 1 week after hospital admission, or if the patient has no clinical diagnosis of CAP at the time of admission. Patients referred from or transferred to another hospital are excluded.
After identification of eligible patients upon microbiological results, medical records are reviewed using a standardized data collection questionnaire. Comorbidity is determined using the Charlson comorbidity index [10]. Additionally, all patients are classified according to the multimorbidity patterns proposed by Holden et al. [12]. These are:
- arthritis, osteoporosis, other chronic pain, bladder problems, and irritable bowel;
- asthma, chronic obstructive pulmonary disease, and allergies;
- back/neck pain, migraine, other chronic pain, and arthritis;
Sponsor: University of Zurich
Current Primary Outcome: In-hospital mortaliy [ Time Frame: From day of admission until discharge or dead ]
Mortality during hospitalization because of pneumococcal pneumonia
Original Primary Outcome:
Current Secondary Outcome:
Original Secondary Outcome:
Information By: University of Zurich
Dates:
Date Received: September 7, 2012
Date Started: October 2012
Date Completion:
Last Updated: May 26, 2014
Last Verified: May 2014
