Antibiotics initiated for suspected community-acquired pneumonia even when chest radiography results are negative

Relationship between chest radiography results and antibiotic initiation in community-acquired pneumonia management by general practitioners

2024-11-25

(Press-News.org) Original Research

Background and Goal: This study explored how chest X-ray results influence antibiotic initiation by general practitioners in France when managing patients with suspected pneumonia.

Study Approach: A prospective cross-sectional study was conducted with adult patients with suspected pneumonia who received chest X-rays as part of their evaluation. To analyze factors associated with antibiotic initiation, patients’ characteristics were compared at inclusion and at 28 days between patients with positive chest X-rays (indicating pneumonia) and patients with negative chest X-ray results.

Main Results: The sample included 259 adult patients. The median age was 58 years, 120 (46.3%) were male, 249 (96.1%) had not received antibiotics prior to inclusion, and 69 (26.7%) had at least one risk factor for pneumococcal disease.

Most of the general practitioners who included patients were women (55.2 %; n = 153), with a median age of 39 years. 76.1% (n = 210) were general practitioner trainers. 55.6% of patients (144 out of 259) had positive chest X-ray results. Patients with positive chest X-ray results had higher body temperature, faster heart rate, faster breathing rate, more difficulty breathing, and more frequent unilateral chest pain than patients with negative X-ray results, and their symptoms lasted for a longer time. 99.3% of patients with positive chest X-ray results received antibiotics. Despite fewer symptoms and negative chest X-ray results, a significant portion (68.75%) of patients with negative chest X-ray results were prescribed antibiotics (79/115 patients). Why It Matters: The findings of this study show that many general practitioners prescribe antibiotics for suspected community-acquired pneumonia even when chest X-ray results are negative, highlighting a gap between guidelines and actual practice.

Relationship Between Chest Radiography Results and Antibiotic Initiation in Community-Acquired Pneumonia Management by General Practitioners

Juliette Pinot, MD, et al

Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France

Université Paris Cité, Department of General Practice, Paris, France

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