Measuring acceptable treatment failure rates for community-acquired pneumonia: potential for reducing duration of treatment and antimicrobial resistance

Keith S Kaye; Anthony D Harris; Jay R McDonald; Larry J Strausbaugh; Eli Perencevich; Infectious Diseases Society of America Emerging Infections Network

doi:10.1086/526436

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Measuring acceptable treatment failure rates for community-acquired pneumonia: potential for reducing duration of treatment and antimicrobial resistance

Journal article

Open access

Peer reviewed

Measuring acceptable treatment failure rates for community-acquired pneumonia: potential for reducing duration of treatment and antimicrobial resistance

Keith S Kaye, Anthony D Harris, Jay R McDonald, Larry J Strausbaugh, Eli Perencevich and Infectious Diseases Society of America Emerging Infections Network

Infection control and hospital epidemiology, Vol.29(2), pp.137-142

02/2008

DOI: 10.1086/526436

PMID: 18171306

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Abstract

This study was designed to establish the rates of treatment failure for community-acquired pneumonia that are acceptable to knowledgeable and experienced physicians, in order to facilitate the interpretation of existing studies and the design of new studies aimed at optimizing the duration of antibiotic therapy. Reducing the duration of antibiotic therapy is one strategy for reducing antibiotic exposure and thereby minimizing the potential for the emergence of antimicrobial resistance. Survey soliciting the acceptable failure rate for treatment given to an adult patient with uncomplicated community-acquired pneumonia treated with standard-of-care therapy in the outpatient setting. Analysis was performed using a modification of established methods of contingent valuation analysis. Six hundred eighty infectious diseases physicians in North America who were also members of the Emerging Infections Network of the Infectious Diseases Society of America. Three hundred seventy-five (55.1%) of 680 physicians responded to the survey. The median acceptable failure rate for treatment was 13.5%. Five hundred ten respondents (75.0%) found a failure rate of 7.3% acceptable, and 170 respondents (25.0%) found a failure rate of 19.8% acceptable. This study identified the failure rates for treatment of community-acquired pneumonia that were acceptable to infectious disease physicians. This range of acceptable treatment failure rates may facilitate the design of studies aimed at optimizing the duration of antimicrobial therapy for community-acquired pneumonia.

Physicians

Humans

Male

Data Collection

Practice Patterns, Physicians

Anti-Bacterial Agents - therapeutic use

Community-Acquired Infections - drug therapy

Treatment Failure

Adult

Female

Pneumonia, Bacterial - drug therapy

Surveys and Questionnaires

Anti-Bacterial Agents - administration & dosage

Research Design

Details

Title: Subtitle: Measuring acceptable treatment failure rates for community-acquired pneumonia: potential for reducing duration of treatment and antimicrobial resistance
Creators: Keith S Kaye - Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
Anthony D Harris
Jay R McDonald
Larry J Strausbaugh
Eli Perencevich
Infectious Diseases Society of America Emerging Infections Network
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.29(2), pp.137-142
DOI: 10.1086/526436
PMID: 18171306
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 0899-823X
eISSN: 1559-6834
Publisher: United States
Grant note: K12 RR023249-01 / NCRR NIH HHS K23 AG23621-01A1 / NIA NIH HHS K23 AI01752-01AI / NIAID NIH HHS R01 AI60859-01A1 / NIAID NIH HHS U50 CCU112346 / PHS HHS
Language: English
Date published: 02/2008
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9984001166302771

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