Appropriate prescribing of azithromycin for community-acquired pneumonia
Sue Qian1,2, Johnny Siu1,2, Abbas Hussein1
1Department of Respiratory and Sleep Medicine, St George Hospital, Sydney, New South Wales, Australia.
Abstract:
Azithromycin is prescribed for atypical antimicrobial cover in severe community-acquired pneumonia. Inappropriate azithromycin administration incurs unnecessary financial costs, exacerbates antimicrobial resistance and risks QTc interval prolongation leading to cardiac arrhythmias. The present study demonstrated that a majority of patients were prescribed azithromycin without having electrocardiograms to assess the QTc interval and without meeting criteria for severe community-acquired pneumonia based on CURB-65 score.
Insights
Many patients inappropriately receive azithromycin for pneumonia, risking side effects and antimicrobial resistance. This study found most patients lacked ECGs and severe pneumonia criteria before azithromycin prescription.
Area of Science:
- Medical research
- Pharmacology
- Infectious diseases
Background:
- Azithromycin is used for severe community-acquired pneumonia (CAP).
- Inappropriate use leads to costs, resistance, and QTc prolongation (cardiac arrhythmias).
Purpose of the Study:
- To evaluate azithromycin prescribing practices in CAP.
- To assess adherence to guidelines regarding QTc interval monitoring and CURB-65 scoring.
Main Methods:
- Retrospective chart review of patients prescribed azithromycin for CAP.
- Analysis of ECG availability and CURB-65 scores at the time of prescription.
Main Results:
- A majority of patients received azithromycin without prior ECGs.
- Most patients did not meet CURB-65 criteria for severe CAP.
Conclusions:
- Azithromycin prescribing for CAP is often inappropriate.
- Current practices risk adverse events and contribute to antimicrobial resistance.
More Related Videos
07:46Use of Artificial Sputum Medium to Test Antibiotic Efficacy Against Pseudomonas aeruginosa in Conditions More Relevant to the Cystic Fibrosis Lung
Published on: June 5, 2012
09:26Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung
Published on: January 22, 2021
Related Concept Videos
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Pneumonia III: Complications and Assessment
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...