Hospital management of community-acquired pneumonia in Malta

Abstract

Community-acquired pneumonia (CAP) remains a common diagnosis requiring hospital admission and a leading cause of death worldwide. No local guideline is currently available for the management of CAP. Our aim was to evaluate current practices in the management of CAP at Mater Dei Hospital, Malta. In this prospective study we looked at all adult patients admitted with CAP in winter and summer (105 consecutive days for both seasons). Data collected and analysed included: basic patient demographics; symptoms at presentation; antibiotics prescribed and time of administration; co-morbidities; CURB65; blood oxygenation levels; admission plan; length of stay and follow-up; length of stay, follow-up chest radiography and death within 30 days from hospital admission. Of note the average time to first dose antibiotic was 7 hours 48 minutes (range 2 hours 13 minutes – 14 hours 17 minutes). A total of 178 patients (50.1%) were admitted with CURB65 scores of 0 (n=99) and 1 (n=86). Most of these could have been discharged and managed in the community with significant impact on hospital bed occupancy. Eventual standardisation of acute management of CAP by the set-up of a local guideline will improve outcome and reduce hospital bed occupancy.