Results of survey of adult community-acquired pneumonia utilizing flow chart of diagnostic guideline for management of respiratory infections

Akira Watanabe, Toshiharu Matsushima, Shigeru Kohno, Shosaku Abe, Nobuki Aoki, Keishi Kubo, Yukihiko Sugiyama, Norio Kikuchi, Shoji Kudou, Yoshiaki Ishigatsubo, Kaoru Shimokata, Kazuto Hirata, Yuji Tohda, Nobuhiro Narita, Nobuo Ueda, Yoshihito Niki, Masaru Nasu, Atsushi Saitou

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

We performed a nationwide survey of 1,258 patients to assess the treatment of community-acquired pneumonia in Japan. Cases were classified as bacterial pneumonia in which the causal organism was unknown (Type A) or presumed (Type B), atypical pneumonia (Type C), severe pneumonia (Type D), or pneumonia in certain specific morbid states (Type E). Our objectives were to assess the actual use of antimicrobials and to determine the usefulness of the "Guidelines on Respiratory Infections--Basic Concepts in the Medical Care of Community-Acquired Pneumonia in Adults", developed by the Guideline-Drafting Committee of the Japanese Respiratory Society (JRS), in differentiating these categories of patients. We also hoped to elicit constructive opinions that would contribute to future revisions of these guidelines. The findings showed that pneumonia was classified as "bacterial pneumonia in which the causal organism was unknown" in approximately half (50.2%) of the patients studied. The next most common classification was "severe pneumonia", followed by "atypical pneumonia", "bacterial pneumonia in which the causal organism was presumed", and "pneumonia in certain specific morbid states", in that order. Our results suggest that the JSR guidelines, including the methods for differentiating between bacterial pneumonia and atypical pneumonia, are useful and appropriate, and that antimicrobial agents were generally selected in accordance with the guidelines. We also identified a number of issues to be addressed in future updates of the guidelines, including criteria for physiological assessment, handling of cases in which physical findings and laboratory test results are not in agreement, age-related issues (especially the treatment of patients 65 years of age and older), the differentiation between bacterial pneumonia and atypical pneumonia, the weighing of underlying diseases and complications, and guidelines regarding the use of adjuvant therapy.

Original languageEnglish
Pages (from-to)781-796
Number of pages16
JournalNihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
Volume41
Issue number11
Publication statusPublished - 2003 Nov
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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