A PEER-REVIEWED JOURNAL OF RESEARCH AND CLINICAL MEDICINEISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
Ru
En

Errors in the Diagnosis and Treatment of Community-acquired Pneumonia

For citation: Bolotova E. V., Shulzhenko L. V., Porkhanov V. A. Errors in the Diagnosis and Treatment of Community-acquired Pneumonia. Doctor.Ru. 2017. 10(139): 37–39.
20 October 00:00

Study Objective: To analyze errors made by primary-care physicians (PCP) when diagnosing or treating community-acquired pneumonia (CAP) in different districts of Krasnodar Region.

Study Design: This was a retrospective study.

Materials and Methods: The medical charts of 1,500 hospitalized patients and outpatients treated by PCP in Krasnodar and 45 municipal districts of Krasnodar Region were analyzed and reviewed for conformance with the national clinical guidelines on the diagnosis and treatment of CAP. Statistica 7.0 software was used for statistical analysis of the study data.

Two clinical cases have been included to illustrate incorrect management strategies used for patients with CAP.

Study Results: In ambulatory settings, the most common errors in the diagnosis and treatment of CAP included underestimation of pneumonia severity and failure to administer pulse oximetry with the objective of assessing severity of respiratory failure (non-compliance with the national guidelines) (71.3%); and the use of inadequate antibiotic regimens (53.5%). It is noteworthy that 71.4% of the patients were late in seeking a PCP’s attention. In hospital settings the most commonly reported problems were failure to administer pulse oximetry (85.9%), delayed transfer to an intensive care unit (80.0%), and underestimating the severity of the patient’s condition (78.5%).

Conclusion: Strict compliance with the national clinical guidelines on the diagnosis and initial empirical antimicrobial treatment will significantly reduce the number of errors in diagnosing CAP and treating patients with this condition, and will improve their prognosis.

E. V. Bolotova — Kuban State Medical University, Krasnodar. Research Institute, Professor S. V. Ochapovsky Territorial Clinical Hospital No. 1, Krasnodar. E-mail: bolotowa_e@mail.ru

L. V. Shulzhenko — Kuban State Medical University, Krasnodar. Research Institute, Professor S. V. Ochapovsky Territorial Clinical Hospital No. 1, Krasnodar. Е-mail: larisa_shulzhenk@mail.ru

V. A. Porkhanov — Kuban State Medical University, Krasnodar. Research Institute, Professor S. V. Ochapovsky Territorial Clinical Hospital No. 1, Krasnodar. Е-mail: vladimirporhanov@mail.ru

Доктор.ру
20 October 00:00
LITERATURE
  1. Чучалин А. Г., Синопальников А. И., Козлов Р. С., Авдеев С. Н., Тюрин И. Е., Руднов В. А. и др. Клинические рекомендации по диагностике, лечению и профилактике тяжелой внебольничной пневмонии. Пульмонология. 2014; 4: 13–48. [Chuchalin А. G., Sinopal'nikov А. I., Kozlov R. S., Аvdeev S. N., Tyurin I. E., Rudnov V. А. i dr. Klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike tyazheloj vnebol'nichnoj pnevmonii. Pul'monologiya. 2014; 4: 13–48. (in Russian)]
  2. Чучалин А. Г., Синопальников А. И., Козлов Р. С., Тюрин И. Е., Рачина С. А. Внебольничная пневмония у взрослых. Практические рекомендации по диагностике, лечению и профилактике. Клин. микробиол. антимикроб. химиотер. 2010; 12(3): 186–225. [Chuchalin A. G., Sinopal'nikov A. I., Kozlov R. S., Tyurin I. E., Rachina S. A. Vnebol'nichnaya pnevmoniya u vzroslykh. Prakticheskie rekomendatsii po diagnostike, lecheniyu i profilaktike. Klin. mikrobiol. аntimikrob. khimioter. 2010; 12(3): 186–225. (in Russian)].
  3. Woodhead M., Blasi F., Ewig S., Garau J., Huchon G., Ieven M. et al. Joint Taskforce of the European Respiratory Society and European Society for Clinical Microbiology and Infectious Diseases. Clin. Microbiol. Infect. 2011; 17(suppl 6): E1–59.
  4. Райчева М. В., Биличенко Т. Н., Чучалин А. Г. Клинико-эпидемиологические особенности пневмонии у мужчин молодого возраста в организованных коллективах. Пульмонология. 2016; 26(1): 29–37. [Rajcheva M. V., Bilichenko T. N., Chuchalin А. G. Kliniko-ehpidemiologicheskie osobennosti pnevmonii u muzhchin molodogo vozrasta v organizovannykh kollektivakh. Pul'monologiya. 2016; 26(1): 29–37. (in Russian)]
  5. Биличенко Т. Н., Быстрицкая Е. В., Чучалин А. Г., Белевский А. С., Батын С. З. Смертность от болезней органов дыхания в 2014–2015 гг. и пути ее снижения. Пульмонология. 2016; 26(4): 389–97. [Bilichenko T. N., Bystritskaya E. V., Chuchalin А. G., Belevskij А. S., Batyn S. Z. Smertnost' ot boleznej organov dykhaniya v 2014–2015 gg. i puti ee snizheniya. Pul'monologiya. 2016; 26(4): 389–97].
  6. Restrepo M. I., Mortensen E. M., Rello J., Brody J., Anzueto A. Late admission to the ICU in patients with community-acquired pneumonia is associated with higher mortality. Chest. 2010; 137(3): 552–7.
  7. Brown S. M., Dean N. C. Defining severe pneumonia. Clin. Chest. Med. 2011; 32(3): 469–79.
  8. Viasus D., Simonetti A., Garcia-Vidal C., Carratalà J. Prediction of prognosis by markers in community-acquired pneumonia. Expert Rev. Anti Infect. Ther. 2013; 11(9): 917–29.
  9. Рачина С. А., Дехнич Н. Н., Козлов Р. С., Бобылёв А. А., Батищева Г. А., Гордеева С. А. и др. Оценка тяжести внебольничной пневмонии в реальной клинической практике в многопрофильных стационарах Российской Федерации. Пульмонология. 2016; 26(5): 521–8. [Rachina S. А., Dekhnich N. N., Kozlov R. S., Bobylev А. А., Batishheva G. А., Gordeeva S. А. i dr. Otsenka tyazhesti vnebol'nichnoj pnevmonii v real'noj klinicheskoj praktike v mnogoprofil'nykh statsionarakh Rossijskoj Federatsii. Pul'monologiya. 2016; 26(5): 521–8. (in Russian)]
  10. Хамитов Р. Ф. Внебольничная пневмония: немедикаментозные факторы риска летального исхода. Пульмонология. 2014; 1: 23–6. [Khamitov R. F. Vnebol'nichnaya pnevmoniya: nemedikamentoznye faktory riska letal'nogo iskhoda. Pul'monologiya. 2014; 1: 23–6. (in Russian)]

News

30 June 00:00
A New Issue of Doctor.Ru Neurology Psychiatry, Vol. 20, No. 5 (2021), Published

Find original articles and reviews covering various aspects of neurology, psychiatry and the interview with Professor Marina Arkadievna Kinkulkina

28 June 00:00
A New Issue of Doctor.Ru Internal Medicine, Vol. 20, No. 4 (2021), Published

Find original articles and reviews covering various aspects of cardiology, gastroenterology, internal medicine and the interview with Professor Elena Zelikovna Golukhova

 

3 May 17:06
A New Issue of Doctor.Ru Pediatrics, Vol. 20, No. 3 (2021), Published

Find original articles and reviews covering various aspects of pediatrics and the interview with Professor Evgeny Grigorievich Furman

3 May 17:06
A New Issue of Doctor.Ru Endocrinology, Vol. 20, No. 2 (2021), Published

Find original articles and reviews covering various aspects of endocrinology and the interview with Professor Valentin Viktorovich Fadeev

16 April 11:57
Igor Evgenievich Khatkov joined the American Surgical Association

Igor Evgenievich Khatkov, Head of A. S. Loginov Moscow Clinical Scientific and Practical Centre, Chief Oncologist in and for Moscow is now an honoured member of the American Surgical Association.

All news