Treatment of community-acquired pneumonia: a descriptive study in an Apulian department of internal medicine.

Background: Infections of the lower airways pose a serious problem for the health service, both because of the burden of the disease and becaus of the large number of resources that need to be devoted to treating it. Material/Methods: The present study describes the use of antibiotics to treat acute bronchopneumonia in the Internal Medicine Department "Cesare Frugoni" of university hospital in southern Italy. A total of 493 patients were studied during a 4.5-year period. Results: In 98.2% of cases an empirical approach to treatment was adopted, and only in 57 patients was targeted treatment administered. Mean duration of the antibiotic therapy was 11.3 days, with a wide range. Assessment of prognosis in the different groups showed that this did not seem to depend on the type of treatment approach or on the type and/or number of antibiotics used. Instead, targeted therapy was correlated with a shorter duration of treatment. Blood culture was very rarely carried out. The almost invariably empirical approach to treatment of bronchopneumonia infections resulted in longer hospital stay and a greater consumption of antibiotics, often of latest generation. Conclusions: Therefore, more studies would be useful to investigate the real adherence to the guidelines in the clinical practice. Finally, blood culture should be performed routinely in these patients, although the time required for the test could be a limiting factor.