Use of ECDC PPS HAI&AU data to evaluate adherence to national guidelines for antimicrobial treatment of community acquired pneumonia

Abstract

INTRODUCTION Point prevalence surveys are widely described as a useful tool for evaluating antimicrobial policy and adherence to guidelines. OBJECTIVES We aimed to investigate if data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey of healthcare associated infections and antimicrobial use (PPS HAI&AU) can be used to evaluate adherence to national guidelines for the treatment of community acquired pneumonia (CAP) and to analyze the quality of treatment regimens. PATIENTS AND METHODS Data for 72 698 patients were collected in Poland between the years 2012 and 2015 according to the ECDC Protocol v.4.2. CAP was an indication for antimicrobial treatment in 3608 patients. Patients hospitalized longer than 48 hours were excluded. A total of 667 patients met the inclusion criteria, and 79 regimens were recorded and evaluated as concordant or discordant with the guidelines. Afterwards, 7 experts scored the regimens from 1 to 5. The averages were calculated, and the results below 3.0 were considered as not optimal and those of 3.0 or higher-As optimal. Coherence of the experts' scores was evaluated. RESULTS Of all patients, 153 (22.8%) were treated exactly according to the guidelines. Nineteen regimens (24.0%) were optimal but discordant with the guidelines; they were administered to 346 patients (51.9%). The remaining 50 regimens (63.3%) were evaluated as discordant and not optimal and were used in 169 patients (25.3%). The correlation results of the experts' scores were significant. CONCLUSIONS ECDC PPS HAI&AU data can be efficiently used to assess adherence to guidelines. Despite low adherence (22.8%), almost 75% of patients received optimal antimicrobial treatments. Actions promoting the guidelines and time series studies analyzing improvement of adherence should be considered.