AN AUDIT OF THE ASSESSMENT AND MANAGEMENT OF ADULTS ADMITTED TO CHRISTCHURCH-HOSPITAL WITH COMMUNITY-ACQUIRED PNEUMONIA

Aims. To audit the management of adult patients admitted with communit y acquired pneumonia including the standards of clinical assessment, u se of modified British Thoracic Society prognostic criteria and antibi otic therapy. Methods. A prospective, 16 week, study of consecutive pa tients admitted to Christchurch Hospital with community acquired pneum onia. Results. Ninety-six patients met the inclusion criteria. The med ian age was 70 years. A pathogen was identified in 28 (26%) patients. Forty two patients fulfilled the modified British Thoracic Society cri teria for severe disease and all 9 deaths occurred in that subgroup. T he management guidelines were followed without exception in only 15% o f cases. Documentation of the prognostic criteria was often incomplete and therefore only 33% of those patients with severe disease were cor rectly identified. Seventy one percent of those with severe disease we re treated with only one antibiotic and there was significant delay in administering the first dose in 44% of cases. A follow up chest radio graph was performed in 43 (51%) of those discharged. Conclusions. Ther e was poor compliance with the management guidelines. There was a lack of awareness of the severity criteria leading to inadequate treatment in many cases. Further educational initiatives are indicated.