In 2005, the IDSA and ATS issued guidelines on the treatment of pneumonia in hospitalized patients, and included a new categorization of healthcare-associated pneumonia (HCAP) for patients with recent interface with medical facilities (guidelines). In this prospective cohort, researchers identified 362 patients with CAP, HAP, or HCAP, and determined rates of guideline-appropriate treatment and mortality. Patients with HCAP were much less likely to receive guideline-concordant antibiotics (27%) than patients with CAP (59%) or HAP (69%), and their mortality was much higher (18%) than patients with CAP (7%) (abstract). As a reminder, HCAP patients include: nursing home or long-term care facility residents, anyone hospitalized (2+ days) in the last 90 days, or anyone undergoing hemodialysis / wound care / chemotherapy / IV antibiotics in the last 30 days. These patients should be treated with 2 anti-pseudomonal drugs and 1 anti-MRSA drug (guidelines)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.