Adherence to the practice guideline of community acquired pneumonia in the Hospital Universitario San Jorge, Pereira, Colombia

Objetive: To determine the variables associated with nonadherence to practice guideline of Community Acquired Pneumonia CAP in the Hospital Universitario San Jorge of Pereira (HUSJ). Methods: Cross-sectional study of all patients over 18 years of either sex with a diagnosis of NAC between January 1, 2010 and March 30, 2012. The information was taken from the medical records considering socio-demographic, clinical (diagnosis, symptoms, comorbidities), paraclinical (leukogram, X-ray, blood cultures) and therapeutic variables (time of hospitalization and medication costs). Adherence was determined according to the fulfillment of this guide. 2 tests and logistic regression were applied. Results: We found 297 cases of NAC, with slight male predominance (159 men vs 138 women) and mean age 56.3±22.4 years. Adherence to the practice guideline was 14.1% of cases. The antibiotics used were Ampicillin + Sulbactam in 180 patients (60.6% of cases), Ceftriaxone in 53 (17.8%) and Clarithromycin in 31 (10.4%). Blood cultures were 92 and 8.6% reported gram-positive cocci. The low cost of hospitalization (p=0,03, OR:2,07; 95%CI: 1,02-4,14) and chest X-ray report (p<0,001, OR:16,7; 95%CI:2,26-124,11)was statistically significantly associated with adherence to the guide. Non-adherence was associated with lack of guidance from physicians. Discussion: The HUSJ should update your practice guideline and socialize NAC care among physicians and follow up the implementation to reduce hospital stay, complications and costs.