Manejo de la neumonía comunitaria del adulto en el Servicio de Salud Viña del Mar-Quillota. Abril - Septiembre de 2003

Abstract

Community-acquired pneumonia (CAP) is a potentially serious infection that results in numerous general practitioner visits and hospital admissions each year. Objective: to evaluate the clinical management of CAP by general practitioners in the emergency setting. Results: From April 1 to September 30, 2003, 3,701 adult cases of CAP were reported in Viña del Mar and Quillota Health Service, 73% of cases presented to emergency department and 27% to primary care units. Overall, 84% were treated as ambulatory patients and 16% were admitted to hospital. During a 6-month period, 229 ambulatory patients with CAP ( ± SD = 56 ± 21 years old) were prospectively evaluated in the emergency setting. Patients with CAP class I (40%) were treated with Clarithromycin (67.4%) or Amoxicillin (32.6%) during 10 days; and CAP type II cases (60%) were treated with Amoxicillin-clavulanate (74.5%) or Levofloxacin (24.8%) during 10 days. 226 of initial ambulatory patients (98.7%) were cured without hospitalization; three patients (1.3%) were subsequently hospitalized because of the failure of ambulatory treatment. Overall, three patients (1.3%) died; all deaths occurred during or immediately after hospitalization and were related to the severity of lung infection but not to the choice of antibiotic treatment. Conclusions: The majority of adult patients with CAP, without clinical severity criteria, could be managed as outpatients with low rates of hospital admission and mortality