Infect Chemother.  2013 Dec;45(4):394-405. 10.3947/ic.2013.45.4.394.

A 2011-2012 Survey of Doctors' Perceptions of Korean Guidelines and Empirical Treatment of Community-Acquired Pneumonia

Affiliations
  • 1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. ksw2kms@knu.ac.kr
  • 2Department of Internal Medicine, Samsung Medical Center, Seoul, Korea.

Abstract

BACKGROUND
The causative pathogens of and prevalence of antibiotic resistance in community-acquired pneumonia (CAP) varies across countries. We evaluated the patterns of antibiotic prescriptions for adult CAP patients, and physician satisfaction with the form and content of the 2009 Korean CAP treatment guidelines.
MATERIALS AND METHODS
We designed an online survey for clinical physicians who treat CAP (infectious disease specialists, pulmonologists, and other physicians). We e-mailed the online survey to physicians and gathered results from December 2011 to January 2012, and then analyzed their responses.
RESULTS
A total of 157 physicians responded to our survey: 61 (38.9%) infectious disease specialists, 33 (21.0%) pulmonologists, and 63 (40.1%) other physicians. Two-thirds (96/157, 61.2%) had positions in tertiary and secondary hospitals; the others (61, 38.8%) worked in primary clinics (hospitals and private clinics). One hundred and eight (68.8%) were aware of the Korean CAP clinical guidelines; of these, 98 (62.4%) applied the guidelines to their practice. Among physicians using them, 86.7% (85/98) reported the guidelines to be most useful for empirical selection of antibiotics, and 75.2% (118/157) said the guidelines were useful and satisfactory. Sixty-eight (43.3%) respondents indicated that they had not used aminoglycosides as an initial empirical CAP treatment, while 51 (32.5%) had combined aminoglycosides with other antibiotics to treat patients with CAP. Seventy-three (46.5%) physicians often combined macrolides with beta-lactam antibiotics for empirical treatment of CAP, and 21 (13.4%) reported using macrolide monotherapy (which is not recommended in the 2009 Korean CAP treatment guidelines) for CAP patients. The most commonly used beta-lactams were third-generation cephalosporins (72, 45.9%) and ampicillin/sulbactam or amoxicillin/clavulanate (28, 17.8%).
CONCLUSIONS
Some physicians remain unaware of the 2009 Korean treatment guidelines for CAP and do not use them in clinical practice. In addition, aminoglycoside combination therapy is frequently and inappropriately used in practice. In some cases, CAP is treated with macrolide monotherapy. Thus, the Korean CAP clinical guidelines must be more aggressively and continuously publicized.

Keyword

Pneumonia; Guidelines; Antibiotics

MeSH Terms

Adult
Aminoglycosides
Anti-Bacterial Agents
beta-Lactams
Cephalosporins
Communicable Diseases
Drug Resistance, Microbial
Electronic Mail
Humans
Macrolides
Pneumonia*
Prescriptions
Prevalence
Specialization
Surveys and Questionnaires
Aminoglycosides
Anti-Bacterial Agents
Cephalosporins
Macrolides
beta-Lactams

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