Managing outpatients with community-acquired pneumonia. A prospective study with a network of 95 general practitioners

A prospective survey involving a group of 95 general practitioners (GPs) wa s carried out from February 1993 to March 1994 to assess the frequency of c ommunity-acquired pneumonia (CAP) in ambulatory practice and the management of CAP by GPs. A total of 173 CAP, defined as the onset of fever associate d with focal pulmonary crackles and/or radiological changes consistent with a pulmonary infection, were reported, giving an average 1.7 cases of CAP p er GP per year. A total of 37 (21.3 %) patients were admitted to hospital. Initial clinical presentation with the classical association "cough, thorac ic pain, and dyspnea" was reported in 22 % of the patients. No blood cultur e and no sputum examination were performed prior to treatment. First line a ntibiotic therapy was a monotherapy for 143 (92.8 %) patients: amoxi.-ac. c lav. (34.3 %), amoxi. (23.1 %), macrolides (16.1 %), 1st/2nd generation cep halosporins (11.9 %), ceftriaxone (8.4 %), oral broad spectrum cephalosposi ns (2.8 %), quinolones (2.1 %). 34 (22.1 %) patients failed to improve: 16 (10.4 %) had a second line antibiotic therapy at home, and 18 (11.7 %) were hospitalised. 5 (2.9 %) patients died at hospital (13.5 % of hospitalized patients).