Antibiotic Duration Frequently Exceeds Recommendations in Patients With CAP

Over 70% of patients with uncomplicated community-acquired pneumonia (CAP) received prescriptions for antibiotics that exceeded national duration recommendations, according to a recent study.

The retrospective study included 22,128 patients from 18 to 64 years of age with private insurance and 130,746 patients aged 65 years and older with Medicare who were hospitalized with uncomplicated CAP. Length of antibiotic therapy (LOT) during hospital stay was estimated using the MarketScan Hospital Drug Database and outpatient LOT was determined using prescriptions filled at discharge. The researchers defined excessive duration as a LOT of more than 3 days.
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Overall, 74% of patients from 18 to 64 years of age and 71% of patients aged 65 years and older received prescriptions for antibiotics that exceeded national recommendation for duration. The median total LOT was 9.5 days. Patients from 18 to 64 years of age had a median outpatient LOT of 6 days and patients aged 65 years and older had a median outpatient LOT of 5 days.

“In this nationwide sample of patients hospitalized for uncomplicated CAP, median total LOT was just under 10 days, with over 70% of patients having likely excessive treatment duration,” the researchers concluded. “Better adherence to recommended duration of therapy for CAP by improving prescribing at hospital discharge may be an important target for antibiotic stewardship programs.”

—Melissa Weiss

Reference:

Yi SH, Hatfield KM, Baggs J, et al. Duration of antibiotic use among adults with uncomplicated community-acquired pneumonia requiring hospitalization in the United States [published online November 6, 2017]. Clin Infect Dis. https://doi.org/10.1093/cid/cix986.