Evaluation of empirical antibiotherapy for acute community-acquired pneumonia prescribed in emergency departments

Abstract Objective The authors assessed the management of community-acquired pneumonia (CAP) and empirical antibiotic prescription in a primary care center. Method A retrospective study was made on medical charts of patients admitted to the emergency department for CAP. Results Seventy-six patients were included. Their mean age was 65 years for a sex ratio of 1.81. Fever (83%) and cough (72%) were the most common symptoms. Chest X-ray was abnormal in 86%. The median CRP value was 138 mg/L (58–235). The median Fine's score was 85.5 (60–127). Blood cultures were sterile for 82.5% of samples. Pneumococcal and legionella antigenuria were performed for 70% of patients, only one was positive for legionella. Antibiotherapy was prescribed to 18 patients before hospitalization. Amoxicillin-clavulanic acid was the most frequently prescribed empirical treatment (48.5%), followed by ceftriaxone (15%). The therapeutic adequation index was calculated at a median of 1.7 by three investigators (0–3.7). Kendall's concordance coefficient for the three investigators was good at 0.86 ( P Discussion Our clinical, radiological, and microbiological data was quite similar to reported data from teaching hospital series except for severity that seemed lower in primary care centers. The therapeutic adequation index is a useful tool to assess the adequacy of antibiotic prescription.