Rationalised prescribing for community acquired pneumonia: a closed loop audit

Aims-To audit the management of community acquired pneumonia before and aft er the introduction of a protocol. To determine the aetiology of pneumonia using routine investigations and polymerase chain reaction (PCR). Methods-Retrospective and prospective audit following the introduction of a management protocol. Prospective cases were investigated routinely and wit h PCR on blood and nasopharyngeal aspirate. Results-There was a significant increase in rational prescribing following introduction of the protocol with 75% of children receiving intravenous pen icillin or erythromycin compared with 26% beforehand. Of 89 children in the prospective group, 51 microbiological diagnoses were achieved in 48 childr en. Seven children had Streptococcus pneumoniae infection, 14 had Mycoplasm a infection, six had pertussis, and one had Chlamydia pneumoniae infection. Twenty three children had a viral cause of which respiratory syncytial vir us was commonest. Conclusions-Introduction of the protocol led to improved prescribing. PCR i ncreased the diagnostic yield and the results support the management protoc ol.