Antibiotic Selection for Community-Acquired Pneumonia

What It Means
The percentage of all (ICU and non-ICU) pneumonia patients who receive an initial antibiotic during the first 24 hours that is consistent with the current North American antibiotic guidelines for Community-Acquired Pneumonia.

Why It Is Important
The North American Antibiotic Guidelines for treatment of community acquired pneumonia are developed by the Centers for Disease Control and other health care organizations. Treatment with the recommended antibiotic is associated with improved survival.

Denominator Excluded Populations

  • Patients less than 18 years of age
  • Patients who have a Length of Stay >120 days
  • Patients with Cystic Fibrosis (Appendix A, Table 3.4)
  • Patients who had no chest x-ray or CT scan that indicated abnormal findings within 24 hours prior to hospital arrival or anytime during this hospitalization
  • Patients receiving Comfort Measures Only on day of or day after arrival
  • Patients enrolled in clinical trials
  • Patients received as a transfer from the emergency department of another hospital
  • Patients received as a transfer from an acute care facility where they were an inpatient or outpatient
  • Patients received as a transfer from one distinct unit of the hospital to another distinct unit of the same hospital
  • Patients received as a transfer from an ambulatory surgery center
  • Patients who have no diagnosis of pneumonia either as the ED final diagnosis/impression or direct admission diagnosis/impression
  • PN patients not in the ICU (PN-6a only)
  • PN patients in ICU (PN-6b only)
  • Patients with an Identified Pathogen as defined in the Data Dictionary
  • Patients with Healthcare Associated PN as defined in the Data Dictionary
  • Patients who are Compromised as defined in the Data Dictionary
  • Patients who only received antibiotics prior to hospital arrival
  • Patients who do not receive any antibiotics within 24 hours after arrival.
  • Patients discharged/transferred to another hospital for inpatient care on day of or day after arrival
  • Patients who left against medical advice or discontinued care on day of or day after arrival
  • Patients who expired on day of or day after arrival
  • Patients discharged/transferred to a federal health care facility on day of or day after arrival
  • Pneumonia patients with another suspected source of infection who did not receive an antibiotic regimen recommended for pneumonia, but did receive antibiotics within the first 24 hours of hospitalization

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