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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

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Front. Med.    2021, Vol. 15 Issue (1) : 139-143    https://doi.org/10.1007/s11684-019-0736-2
RESEARCH ARTICLE
Analysis of antibiotic usage for viral community-acquired pneumonia in adults
Rongmeng Jiang1, Bing Han1, Chang Dou2, Fei Zhou3, Bin Cao3(), Xingwang Li1()
1. Department of Infectious Diseases, Beijing Ditan Hospital, Beijing 100015, China
2. Department of Internal Medicine, Beijing Capital International Airport Hospital, Beijing 100621, China
3. Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
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Abstract

The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.
Keywords adult      antibiotic      viral pneumonia     
Corresponding Author(s): Bin Cao,Xingwang Li   
Just Accepted Date: 29 May 2020   Online First Date: 12 June 2020    Issue Date: 11 February 2021
 Cite this article:   
Rongmeng Jiang,Bing Han,Chang Dou, et al. Analysis of antibiotic usage for viral community-acquired pneumonia in adults[J]. Front. Med., 2021, 15(1): 139-143.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-019-0736-2
https://academic.hep.com.cn/fmd/EN/Y2021/V15/I1/139
Number of viruses Number of patients Percentage Viruses Number of patients Percentage
1 154 92.8% Influenza virus 87 52.4%
Adenovirus 22 13.3%
Rhinovirus 16 9.6%
Parainfluenza virus 10 6.0%
Human metapneumovirus 9 5.4%
Respiratory syncytial virus 9 5.4%
Human coronavirus 1 0.6%
2 9 5.4% Influenza virus+ parainfluenza virus 4 2.4%
Influenza virus+ human coronavirus 2 1.2%
Influenza virus+ adenovirus 2 1.2%
Parainfluenza virus+ human metapneumovirus 1 0.6%
3 3 1.8% Rhinovirus+ respiratory syncytial virus+ adenovirus 2 1.2%
Influenza virus+ adenovirus+ parainfluenza virus 1 0.6%
Total 166 100.0% 166 100.0%
Tab.1  Viruses detected in the study
Index PCT<0.25 0.25≤PCT<0.5 No PCT Total
CRP<20 22 5 37 64
20≤CRP<60 17 0 19 36
CRP≥60 13 4 15 32
No CRP 3 0 28 31
Total 55 9 99 163
Tab.2  Inflammatory index
Drug category Patients with underlying diseases or elderly patients Young adults without underlying diseases
Quinolones 29 40
Cephamycin 10 2
Macrolides 4 5
Cephalosporins 5 6
b-lactam/enzyme inhibitors 7 3
Carbapenem 3 0
Tab.3  Single-drug regimens
Drug category Patients with underlying diseases or elderly patients Young adults without underlying diseases
Macrolides+ cephamycin 2 0
Macrolides+ penicillin 0 1
Macrolides+ b-lactam/enzyme inhibitors 1 4
Macrolides+ cephalosporins 1 5
Quinolones+ b-lactam/enzyme inhibitors 2 19
Quinolones+ cephamycin 2 3
Quinolones+ cephalosporins 0 6
Quinolones+ aminoglycosides 0 1
b-lactam/enzyme inhibitors+ cephamycin 1 0
Macrolides+ cephalosporins+ aminoglycosides 1 0
Tab.4  Combination therapy
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