Evaluation of the compliance to guidelines the diagnosis and treatment in inpatients diagnosed with community-acquired pneumonia and clinical pharmacist approaches, Hacettepe University Faculty of pharmacy

Community-acquired pneumonia (CAP) is a life-threatening disease with high mortality and morbidity. Determining the etiology of CAP in patients is very important to evaluate compliance with the guidelines for empirical therapy. In this study, it was aimed to evaluate the compliance of the treatments with guidelines regarding in diagnosis and empirical antibiotic therapy in CAP, and to evaluate the effect of compliance on patient outcomes, and to determine the role of the clinical pharmacist. Patients aged 18 years hospitalized with CAP at Hacettepe University Hospitals were evaluated in retrospective and prospective periods. Compliance with the guidelines was evaluated with the local hospital CAP diagnosis and treatment guideline and international up-to-date guidelines. A total of 751 patients (423 in retrospective and 328 in the prospective period) were included. The most common bacterial pathogen was H. influenzae (55.9%). 26.4-36.3% of the empirical treatments complied with the international guidelines. While compliance with international guidelines decreased in treatment approaches in the prospective period, compliance with local guidelines increased significantly (p<0.001). The rate of compliance with the guidelines decreased significantly, especially in severely ill patients. It was determined that the 30-day mortality rate and the number of patients with a long hospitalization period were higher in patients who were not treated following the guidelines. The duration of treatment was significantly shortened in the prospective period compared to the retrospective period (p<0.001), the use of fluoroquinolone was decreased (22.9% vs. 2.7%), and the switch to oral treatment was increased (p<0.001). Compliance with guidelines improved to reduce mortality and shorten hospital stays. Improvement of CAP management can be achieved through continuous and comprehensive initiatives to implement the recommendations of guidelines. Keywords: Community-acquired pneumonia, compliance with guidelines, antimicrobial therapy