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. Ad- herence 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 immuno- competent hospitalized patients so as to investi- gate whether the 2003 Infectious Diseases Soci- ety of America update of practice guidelines and the Greek national guidelines for CAP are fol- lowed 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 clas- sified 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 to- wards a shorter length of hospitalization was ob- served in patients treated with an initial antibiot- ic regimen in accordance to guidelines com- pared to those receiving an initial antibiotic regi- men 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 re- duce the financial burden for the National Health System.