Enquête sur la prise en charge thérapeutique des malades hospitalisés pour infection respiratoire basse communautaire

Objectives: The assessment of treatment habits regarding community-acquired lower respiratory tract infections and comparison with current national recommendations. Method: Prospective survey of treatment habits. Patients hospitalised for community-acquired pneumonia in the department of internal medicine, the department of neurology and the department of respiratory diseases (127 beds) at the Sainte-Marguerite Hospital in Marseilles were included. We studied the socio-economical context, the presence of severity factors, the analysis of risk factors, the antibiotic treatments prescribed (type, route of administration, duration) and the outcome of the patients. Results: From November 2001 to February 2002, 98 patients with community-acquired pulmonary infections were included (61 men with a mean age of 72.5 years). The treatment of these patients conformed to guidelines in 79 cases. In 19 cases, the prescription did not conform (unjustified bi-therapy in 8 patients; absence of bi-therapy in suspected cases of intra-cellular bacteria in 4 patients; insufficient dose in 2 patients; and non-adapted antibiotherapy in 5 patients). Conclusion: In the study conditions, the management of community-acquired pneumonia in the hospital most often conformed to current guidelines. Nevertheless, efforts made for initial and continued medical training together with the wide circulation of the guidelines must be continued.