Pneumonia Antibiotic Use in Suspected Cases

This Pneumonia study looked at how chest X-ray data affect antibiotic starting by general practitioners in France when treating patients with probable pneumonia.

Method of study
A prospective cross-sectional investigation was carried out on adult patients with probable pneumonia who underwent chest X-rays as part of their examination. To investigate factors related with antibiotic initiation, patients’ characteristics were compared at inclusion and at 28 days between those with positive chest X-rays (indicating pneumonia) and those with negative chest X-rays.

Main results

The sample comprised 259 adult patients. The median age was 58 years; 120 (46.3%) were men; 249 (96.1%) had not received antibiotics previous to inclusion; and 69 (26.7%) had at least one risk factor for pneumococcal illness.

• The majority of the general practitioners who treated patients were women (55.2%; n = 153), with a median age of 39 years. 76.1% (n = 210) were general practitioner trainers.
• 55.6% of patients (144 out of 259) obtained positive chest X-rays.
• Patients with positive chest X-ray results had greater body temperature, quicker heart rate, faster breathing rate, more trouble breathing, and more frequent unilateral chest discomfort than patients with negative X-ray results, and their symptoms persisted for longer periods of time.
• Antibiotics were prescribed to 99.3% of patients who had positive chest X-ray results. Despite having less symptoms and negative chest X-ray results, 79 out of 115 patients (68.75%) were prescribed antibiotics.

Why does it matter?

This study found that many general practitioners administer antibiotics for suspected community-acquired pneumonia even when chest X-ray results are negative, revealing a gap between guidelines and actual practice.