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The impact of first Timing of antibiotics for community acquired pneumonia in emergency department

  • Yi-Wu Zhou1,2
  • Yan-Qi He3
  • Rong Yao1,2

1Department of Emergency Medicine, Emergency Medical Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China

2Disaster Medical Center, Sichuan University, Chengdu 610041, Sichuan, Chengdu, Sichuan 610041, P. R. China

3Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China

DOI: 10.22514/sv.2020.16.0107 Vol.17,Issue 2,March 2021 pp.20-27

Published: 08 March 2021

*Corresponding Author(s): Rong Yao E-mail: yaorong@wchscu.cn

Abstract

Background and objective: For patients with community-acquired pneumonia (CAP), reported associations between timing of the first dose of antibiotics and short-term mortality are inconsistent. To reduce the risks of antibiotic overuse in the emergency department, this summary of the relevant literature identified patients with CAP who benefit most from early antibiotic administration.

Methods: A PubMed and Google Scholar search was performed for articles concerning the epidemiology, prognosis, diagnosis, and preliminary management of CAP.

Results: Duplicate studies were eliminated and 370 citations were screened. Finally, 16 studies met the eligibility criteria. The review found that, in the presence of sepsis, antibiotics should not be delayed but administered as soon as possible. For patients with moderate-to-severe symptoms, antibiotics should be administered if a diagnosis of CAP is highly likely. For stable, non-critically ill patients with CAP, the timing of antibiotics remains unclear, but available evidence does not indicate strict requirements. For best quality of care, antibiotic timing whether rapid or delayed depends on the clinical situation.

Conclusions: In suspected cases of pneumonia presenting in the emergency department, starting antibiotics early solely to conform to dogmatic guidelines within a rigid timeframe has led to unnecessary antibiotic treatment of uninfected patients, while the outcomes of patients with pneumonia have not improved. Since severity of illness is the key factor associated with poor outcomes in pneumonia, the timing of initial antibiotic treatment should be guided by the severity of symptoms.

Keywords

Pneumonia; Timing; Antibiotics; Outcome

Cite and Share

Yi-Wu Zhou,Yan-Qi He,Rong Yao. The impact of first Timing of antibiotics for community acquired pneumonia in emergency department. Signa Vitae. 2021. 17(2);20-27.

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