A 2011-2012 Survey of Doctors’ Perceptions of Korean Guidelines and Empirical Treatment of Community-Acquired Pneumonia
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Background: The causative pathogens of and prevalence of antibiotic resistance in community-acquired pneumonia (CAP) variesacross countries. We evaluated the patterns of antibiotic prescriptions for adult CAP patients, and physician satisfaction with the formand content of the 2009 Korean CAP treatment guidelines. Materials and Methods: We designed an online survey for clinical physicians who treat CAP (infectious disease specialists, pulmonologists,and other physicians). We e-mailed the online survey to physicians and gathered results from December 2011 to January2012, and then analyzed their responses. Results: A total of 157 physicians responded to our survey: 61 (38.9%) infectious disease specialists, 33 (21.0%) pulmonologists, and63 (40.1%) other physicians. Two-thirds (96/157, 61.2%) had positions in tertiary and secondary hospitals; the others (61, 38.8%)worked in primary clinics (hospitals and private clinics). One hundred and eight (68.8%) were aware of the Korean CAP clinicalguidelines; of these, 98 (62.4%) applied the guidelines to their practice. Among physicians using them, 86.7% (85/98) reported theguidelines to be most useful for empirical selection of antibiotics, and 75.2% (118/157) said the guidelines were useful and satisfactory. Sixty-eight (43.3%) respondents indicated that they had not used aminoglycosides as an initial empirical CAP treatment, while51 (32.5%) had combined aminoglycosides with other antibiotics to treat patients with CAP. Seventy-three (46.5%) physicians oftencombined macrolides with β-lactam antibiotics for empirical treatment of CAP, and 21 (13.4%) reported using macrolide monotherapy(which is not recommended in the 2009 Korean CAP treatment guidelines) for CAP patients. The most commonly used β-lactamswere third-generation cephalosporins (72, 45.9%) and ampicillin/sulbactam or amoxicillin/clavulanate (28, 17.8%). Conclusions: Some physicians remain unaware of the 2009 Korean treatment guidelines for CAP and do not use them in clinicalpractice. In addition, aminoglycoside combination therapy is frequently and inappropriately used in practice. In some cases,CAP is treated with macrolide monotherapy. Thus, the Korean CAP clinical guidelines must be more aggressively and continuouslypublicized.
Abstract
Background: The causative pathogens of and prevalence of antibiotic resistance in community-acquired pneumonia (CAP) variesacross countries. We evaluated the patterns of antibiotic prescriptions for adult CAP patients, and physician satisfaction with the formand content of the 2009 Korean CAP treatment guidelines. Materials and Methods: We designed an online survey for clinical physicians who treat CAP (infectious disease specialists, pulmonologists,and other physicians). We e-mailed the online survey to physicians and gathered results from December 2011 to January2012, and then analyzed their responses. Results: A total of 157 physicians responded to our survey: 61 (38.9%) infectious disease specialists, 33 (21.0%) pulmonologists, and63 (40.1%) other physicians. Two-thirds (96/157, 61.2%) had positions in tertiary and secondary hospitals; the others (61, 38.8%)worked in primary clinics (hospitals and private clinics). One hundred and eight (68.8%) were aware of the Korean CAP clinicalguidelines; of these, 98 (62.4%) applied the guidelines to their practice. Among physicians using them, 86.7% (85/98) reported theguidelines to be most useful for empirical selection of antibiotics, and 75.2% (118/157) said the guidelines were useful and satisfactory. Sixty-eight (43.3%) respondents indicated that they had not used aminoglycosides as an initial empirical CAP treatment, while51 (32.5%) had combined aminoglycosides with other antibiotics to treat patients with CAP. Seventy-three (46.5%) physicians oftencombined macrolides with β-lactam antibiotics for empirical treatment of CAP, and 21 (13.4%) reported using macrolide monotherapy(which is not recommended in the 2009 Korean CAP treatment guidelines) for CAP patients. The most commonly used β-lactamswere third-generation cephalosporins (72, 45.9%) and ampicillin/sulbactam or amoxicillin/clavulanate (28, 17.8%). Conclusions: Some physicians remain unaware of the 2009 Korean treatment guidelines for CAP and do not use them in clinicalpractice. In addition, aminoglycoside combination therapy is frequently and inappropriately used in practice. In some cases,CAP is treated with macrolide monotherapy. Thus, the Korean CAP clinical guidelines must be more aggressively and continuouslypublicized.
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