Análise do manejo de antibioticoterapia em pacientes acometidos por pneumonia adquirida na comunidade

Abstract

To analyze the clinical-pharmacological management of antibiotics in patients affected by Community-Acquired Pneumonia (CAP) in a tertiary hospital in Passo Fundo/RS. Methods: This is a cross-sectional, descriptive and analytical study carried out at the Hospital de Clínicas de Passo Fundo (HCPF). The sample was obtained in a non-probabilistic way defined by convenience from patients treated for PAC at the Hospital de Clínicas de Passo Fundo (HCPF). Statistical analysis was carried out using numerical variables, with measures of position (mean and median) and dispersion (standard deviation, range and interquartile range). Categorical variables were described using absolute (n) and relative frequencies (%). Results: Among the 180 medical records analyzed, males were the largest group of patients treated for CAP (53.9%) with a prevalent age range younger than 5 years (53.3%). The presence of pulmonary comorbidity was more prevalent (48.2%) than cardiovascular comorbidity (10.4%), with bronchopneumonia and bronchial asthma being the main diagnoses, with 73.4% and 46.3%, respectively. Only 1.1% of patients had a sample collected to identify the pathogen, of which the Streptococcus pneumoniae pathogen represented 50%. Regarding antibiotic therapy used according to the Brazilian Society of Pulmonology and Phthisiology (SBTP), 68.9% of patients were covered, with the penicillin class being the most prescribed (53%), with no association between prognosis and treatment. Finally, the prognosis was favorable in 91.7% of patients, even in those who had some type of associated comorbidity, however, there was an association between a worse prognosis in patients with cardiovascular comorbidity (p=0.031). Conclusion: Male patients under 5 years of age were the most prevalent. Among the previous comorbidities, pulmonary ones were the most prevalent, with bronchopneumonia being the main diagnosis. Despite the lack of identification of the pathogen, the antibiotic therapy recommended by SBPT was the most prescribed, with patients under 5 years of age having a greater chance of experiencing drug interactions. Finally, the prognosis was favorable in most patients, however, there is an association with a worse prognosis in patients with previous cardiovascular comorbidities. More studies are needed to better investigate pharmacological management and the relationship between prognosis and different associated comorbidities in patients with CAP.