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Obstacles to penicillin use in treating pneumococcal infection
1Section of Infectious Diseases, Department of Medicine, St. Vincent's Hospital and Medical Center, New York, New York 10011, USA. jillanord@aol.com
Summary
Penicillin use for pneumococcal pneumonia is low due to factors like unrecorded susceptibility results and perceived allergies. Increased physician awareness and education could significantly improve penicillin prescribing for this common infection.
Area of Science:
- Infectious Diseases
- Antibiotic Stewardship
- Clinical Microbiology
Background:
- Pneumococcal pneumonia remains a significant cause of morbidity and mortality.
- Penicillin is a historically effective and cost-efficient antibiotic for treating Streptococcus pneumoniae infections.
- Understanding current prescribing patterns and barriers to penicillin use is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate the utilization patterns of penicillin in treating adult patients with pneumococcal pneumonia.
- To identify factors influencing the prescription of alternative antibiotics over penicillin.
- To assess the impact of antibiotic susceptibility data awareness on treatment choices.
Main Methods:
- Retrospective chart review of adult inpatients diagnosed with pneumococcal pneumonia between December 1998 and October 1999.
- Inclusion criteria: documented pneumococcal pneumonia with Streptococcus pneumoniae isolated from respiratory specimens.
- Data collected: antibiotic usage, patient demographics, antimicrobial susceptibility results, and clinician awareness of susceptibility data.
Main Results:
- Out of 60 identified patients, only 13 (21.6%) received penicillin or ampicillin.
- Antibiotic susceptibility results were missing in the medical records for 21 (35.0%) patients, who did not receive penicillin.
- Reported penicillin allergy (13.3%) and reluctance to use penicillin for intermediate susceptibility (13.3%) were observed barriers.
Conclusions:
- Identified several modifiable barriers hindering optimal penicillin utilization for pneumococcal pneumonia.
- Physician awareness of antibiotic susceptibility results and practitioner education are key to increasing appropriate penicillin use.
- Enhanced education could potentially increase penicillin therapy to two-thirds of eligible patients.
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