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Abstract

TO EVALUATE THE COMPLIANCE WITH ICS/NCCP GUIDELINES IN THE MANAGEMENT OF COMMUNITY ACQUIRED PNEUMONIA IN NORTH INDIAN TERTIARY CARE HOSPITAL

*Payal Preet, Harinder Singh, Vijay K. Sehgal, Vishal Chopra

ABSTRACT

Background: Pneumonia is a common illness having significant morbidity and mortality. Irrational use of antibiotics in the treatment of pneumonia has led to antibiotic resistance, over prescribing and increased cost of treatment. Therefore, the present study was undertaken to evaluate the trends of antimicrobial prescription in community acquired pneumonia. Aim: To evaluate the deviation in the treatment of community acquired pneumonia given in the department of Chest and Tuberculosis, Rajindra Hospital, Patiala from the guidelines (Guidelines for Diagnosis and Management of Community Acquired Pneumonia in Adults: Joint ICS/NCCP Recommendations). Materials and Methods: All the antimicrobial containing prescriptions of community acquired pneumonia were monitored. Data from the prescriptions was entered into data entry forms. Patients of either sex, both in-patients and out-patients were included in the study. The prescriptions were analysed and any deviation in the treatment of community acquired pneumonia from the Indian pneumonia guidelines given by joint ICS-NCCP Committee was evaluated. Results: In present study there was 100% compliance with ICS/NCCP Guidelines with respect to all the investigations. There was no compliance with ICS/NCCP Guidelines with respect to CRB-65 score for risk stratification of patients but there was 100% compliance with guidelines with respect to clinical judgement. There was no compliance with ICS/NCCP Guidelines with respect to duration of treatment for out-patients but there was 72.3% compliance with guidelines with respect to duration of treatment for in-patients. There was 0% compliance with ICS/NCCP Guidelines with respect to antibiotic therapy in out- patients without co-morbidities and 47.05% compliance in-patients without co-morbidities(i.e. 16 patients out of 34 in-patients without co-morbidities) but there was 100% compliance with guidelines with respect to antibiotic therapy in out-patients having associated co-morbidities and 76.9% compliance in in-patients having associated co-morbidities (i.e. 10 patients out of 13 in-patients with co-morbidities). According to the present study, overall percentage compliance calculated for the treatment of community acquired pneumonia given in the department of Chest and Tuberculosis, Rajindra Hospital, Patiala with ICS/NCCP Guidelines is 54.85%.

Keywords: Community acquired pneumonia, antimicrobials, overprescribing, antibiotic resistance, ICS/NCCP Guidelines.


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