Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

The Impact of First Timing of Antibiotics for Community Acquired Pneumonia in Emergency Department

Version 1 : Received: 2 September 2020 / Approved: 3 September 2020 / Online: 3 September 2020 (09:29:32 CEST)

How to cite: Zhou, Y.; Clements, C.M.; Li, M.; He, Y.; Yao, R. The Impact of First Timing of Antibiotics for Community Acquired Pneumonia in Emergency Department. Preprints 2020, 2020090067 (doi: 10.20944/preprints202009.0067.v1). Zhou, Y.; Clements, C.M.; Li, M.; He, Y.; Yao, R. The Impact of First Timing of Antibiotics for Community Acquired Pneumonia in Emergency Department. Preprints 2020, 2020090067 (doi: 10.20944/preprints202009.0067.v1).

Abstract

Background: The reported associations between time to first antibiotic dose after hospital arrival and short-term mortality have varied in prior studies of CAP. It is unclear the benefit of early antibiotics in all patients given the risks of antibiotic overuse and misdiagnosis; Methods: A PubMed and Google Scholar search was performed to identify articles detailing the epidemiology, prognosis, diagnosis, and preliminary management of CAP; Results: In sepsis, antibiotics should not be delayed, and should be administered as soon as possible after recognition. For moderate or severe CAP patients without sepsis, antibiotics should be administered as soon as the diagnosis of CAP is highly likely. For stable, non–critically ill patients with CAP, the timing of antibiotics is not as clear and available evidence does not recommend strict requirements. Antibiotic timing – both rapid and delayed could be used as indicators of quality care in differing clinical scenarios; Results: The dogma of starting antibiotics quickly, within a rigid timeframe of expectations and guidelines has not improved outcomes in pneumonia patients, and has led to an increase in antibiotic treatment in uninfected patients. Severity of illness is the key factor associated with poor outcomes and should more significantly guide the timing of antibiotic initiation.

Subject Areas

Pneumonia; Timing; Antibiotics; Outcome

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