Table 2. Percentage of Antimicrobial Treatment Supported or Unsupported Based on Medical Record Documentation in the CAP Analysis Pathway.
| Pathway criterion | Patients, No. (%) (nā=ā219) | Prescribing quality determination |
|---|---|---|
| No pathogens identified from respiratory or sterile site cultures in first 5 hospital d | ||
| All | 171 (78.1) | NA |
| Did not receive guideline-similar CAP treatment on day 3 of inpatient treatment | 68 (31.1) | Unsupported |
| Received guideline-similar CAP treatment on day 3 of inpatient treatment | ||
| All | 103 (47.0) | NA |
| Treatment duration <8 da | 32 (14.6) | Supported |
| Treatment duration ā„8 da | 71 (32.4) | Unsupported |
| Pathogens identified from respiratory or sterile site cultures in first 5 hospital d | ||
| All | 48 (21.9) | NA |
| Pathogen not susceptible to antimicrobial treatmentb | 3 (1.4) | Unsupported |
| Pathogen susceptible to antimicrobial treatmentb | 45 (20.5) | NA |
| Pathogen cultured from blood, cerebrospinal fluid, or pleural fluid sample | 4 (1.8) | Supported |
| Pathogen not cultured from blood, cerebrospinal fluid, or pleural fluid sample | 41 (18.7) | NA |
| Special pathogen isolatedc | 2 (0.9) | Supported |
| No special pathogens isolated | 39 (17.8) | NA |
| Treatment duration <8 da | 7 (3.2) | Supported |
| Treatment duration ā„8 da | 32 (14.6) | Unsupported |
| Total supported and unsupported CAP treatment | ||
| Supported CAP treatment | 45 (20.5) | NA |
| Unsupported CAP treatment | 174 (79.5) | NA |
Abbreviations: CAP, community-acquired pneumonia; NA, not applicable.
Treatment duration was defined as the duration of inpatient treatment plus the anticipated duration of postdischarge treatment. If postdischarge treatment duration was missing, it was estimated by determining the median days of postdischarge treatment among patients in the same step of the analysis pathway with the same duration of inpatient treatment.
Pathogens were assessed to determine whether they were susceptible (or likely susceptible if no susceptibility data were reported) to at least 1 antimicrobial that the patient was receiving on the day after the microbiology test result was reported to be final.
Special pathogens were defined as Mycobacterium species (other than Mycobacterium gordonae), Aspergillus species, Nocardia species, or other uncommon organisms requiring specialized, prolonged treatment.