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Published on: August 30, 2018
The Impact of the Duration of Antibiotic Therapy in Patients With Community-Onset Pneumonia on Readmission Rates: A
Daniel M Parshall1, Julia E Sessa1, Kelly M Conn2
1Department of Pharmacy, 280227St. Joseph's Health, Syracuse, NY, USA.
Background:
Recent publications have confirmed that 70% of hospitalized adults with uncomplicated community-acquired pneumonia and health-care-associated pneumonia are prescribed a duration therapy that exceeds current guideline recommendations.
Objective:
The primary objective is to evaluate the relationship between antibiotic duration and all-cause 30-day readmission rates. Secondary outcomes include pneumonia-specific 30-day readmission rate and identification of risk factors for readmission.
Methods:
Patients aged ≥18 years with a primary diagnosis of pneumonia from January 1, 2016, to December 31, 2016, were included in this single-center, retrospective cohort study. Patients were categorized by antibiotic therapy duration of ≤7 days (n = 139) or >7 days (n = 286), and outcomes were analyzed in both bivariate and multivariate models. A multivariate logistic regression was used to assess the relationship between all-cause 30-day readmission and antibiotic days.
Results:
Baseline characteristics were not significantly different between the 2 groups. All-cause 30-day readmission rates were 15.8% and 15.5% for patients who received ≤7 days versus >7 days of antibiotics, respectively (P = .95). Pneumonia-specific 30-day readmission occurred in 3.6% of patients who received antibiotics for ≤7 days compared to 3.5% of patients who received antibiotics for >7 days (P = .95). Multivariate logistic regression showed no statistically significant association between readmission rate and antibiotic duration of >7 days. Statistically significant risk factors for readmission identified by logistic regression include ≥3 hospital admissions within the previous year, a hematocrit <30% at discharge, a history of chronic obstructive pulmonary disorder (COPD), and weight.
Conclusion:
The use of prolonged antibiotic therapy for the treatment of community-onset pneumonia was not associated with a decrease in all-cause or pneumonia-specific 30-day readmission rates.
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