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By Targeting Specific Germs, Hospital Hopes to Improve Pneumonia Treatment

e at higher risk of dying.”

To improve the effectiveness of therapy, national guidelines recommend that hospitals base drug selection on the characteristics of the bacteria in their institutions. However, specific recommendations on how to accomplish this are not widely agreed on. Wake Forest Baptist’s report is believed to the first published description of a process using hospital data on infection-causing bacteria to develop institution-specific guidelines for treatment of pneumonia.

The Medical Center project was part of an overall effort to improve care of pneumonia acquired in the hospital. Team members reviewed six months of pneumonia cases from 2004 – a total of 115 cases – to learn which bacteria had caused the pneumonia. They found that at Baptist Hospital, it was patients who had been hospitalized at least 10 days who were most at risk of being infected with bacteria resistant to the most common antibiotics.

The group analyzed each episode of late-onset pneumonia to determine the adequacy of various drug combinations. The goal was to determine which drugs should be used and under what circumstances. They are currently looking at 2006 pathogens to see if the bacteria have changed – which could require an update of the internal guidelines.

In addition to making sure that patients get the most effective therapy, the project also helps the hospital be better stewards of antibiotics, Beardsley said.

“Improper use of antibiotics – whether it is under-dosing, over-use, or prescribing a drug that isn’t effective against the pathogen – hurts our ability to treat the next infected person because resistance can develop,” he said.

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