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Open Access Research article

Resource use by patients hospitalized with community-acquired pneumonia in Europe: analysis of the REACH study

Helmut Ostermann1*, Javier Garau2, Jesús Medina3, Esther Pascual4, Kyle McBride5, Francesco Blasi6 and on behalf of the REACH study group

Author Affiliations

1 Department of Internal Medicine III, Haematology and Oncology, University Hospital Munich, Munich, Germany

2 Department of Medicine, Hospital Universitari Mutua de Terrassa, Plaza Doctor Robert 5, 08221 Terrassa, Barcelona, Spain

3 Medical Evidence Centre, Global Medical Affairs, AstraZeneca, Parque Norte, Edificio Roble, Serrano Galvache 56, 28033 Madrid, Spain

4 Medical Department, Clinical Research Unit, AstraZeneca, Parque Norte, Edificio Roble, Serrano Galvache 56, 28033 Madrid, Spain

5 Instat Services, Inc., 1 Wilson Street, Chatham, NJ 07928, USA

6 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy

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BMC Pulmonary Medicine 2014, 14:36  doi:10.1186/1471-2466-14-36

Published: 5 March 2014

Abstract

Background

Management of community-acquired pneumonia (CAP) places a considerable burden on hospital resources. REACH was a retrospective, observational study (NCT01293435) involving adults ≥18 years old hospitalized with CAP and requiring in-hospital treatment with intravenous antibiotics conducted to collect data on current clinical management patterns and resource use for CAP in hospitals in ten European countries.

Methods

Data were collected via electronic Case Report Forms detailing patient and disease characteristics, microbiological diagnosis, treatments before and during hospitalization, clinical outcomes and health resource consumption.

Results

Patients with initial antibiotic treatment modification (n = 589; 28.9%) had a longer mean hospital stay than those without (16.1 [SD: 13.1; median 12.0] versus 11.1 [SD: 8.9; median: 9.0] days) and higher ICU admission rate (18.0% versus 11.9%). Septic shock (6.8% versus 3.0%), mechanical ventilation (22.2% versus 9.7%), blood pressure support (fluid resuscitation: 19.4% versus 11.4%), parenteral nutrition (6.5% versus 3.9%) and renal replacement therapy (4.2% versus 1.4%) were all more common in patients with treatment modification than in those without. Hospital stay was longer in patients with comorbidities than in those without (mean 13.3 [SD: 11.1; median: 10.0] versus 10.0 [SD: 7.5; median: 8.0] days).

Conclusions

Initial antibiotic treatment modification in patients with CAP is common and is associated with considerable additional resource use. Reassessment of optimal management paradigms for patients hospitalized with CAP may be warranted.

Keywords:
Anti-bacterial agents; Community-acquired pneumonia; Economics; Medical; Retrospective studies