The Evaluation On Clinical Stability Of Community Acquied Pneumonia And Initial Primary Therapy Research In Tianjin

ObjectiveTo investigate the proportion of patients achieving clinical stability after48and72hours of the community acquired pneumonia (CAP) in Tianjin area; Study the factors of Tianjin area which affects the CAP achieved clinical stability; Analysis the factors of adjustment and prognosis of patients with CAP admitted to hospital after antibiotic; Study patients with CAP to follow guide antibiotic selection for the initial treatmentMethodsCollect tianjin area10hospitals in March2010to June2011cases were all CAP, record the CAP to the stability of patients with clinical time, and analysis of the patient’s age, gender, basic diseases, CURB score, admission, before and after use of antibiotics and clinical stable relations; Analysis CAP age, sex, patient basic diseases, CURB score, admission, before and after admission with antibiotic use and after adjustment and prognosis of the antibiotic scheme relationship, record the initial treatment of patients with CAP choice of antibiotic and adjustment comparing different kinds of antibiotic use proportion and the situation.Result1) In701cases of CAP patients, has394patients achieve clinical stability in72hours occupie56.2%of the proportion of all the CAP, and183patients achieve clinical stability in48hours,.The factors that connected to clinical stability are:age、having complications、CURB score(P<0.05).2) The proportions of antibitic of initial primary therapy are:β-lactam mono-therapy (23.4%),β-lactam and macrolide(17.9%),Moxifloxacin monotherapy(13.6%), Levofloxacin monotherapy(12.4%), macrolide monotherapy (8.9%) β-lactam and fluoroqui-nolone(7.8%), aminoglycoside(6.4%),and others(9.2%);were admitted to the hospital after the initial antibiotics choose to use Moxifloxacin patients after72hours antibiotics scheme adjust rates lower thanp-lactam and macrolide a statistically significant difference(P<0.05), and CAP of gender, patients with basic diseases or not, CURB score were not significant.(P>0.05). 3)The prognosis of patients with CAP will only display of age, the age is higher, the treatment effect of the more poor(P<0.05); And CAP of gender, patients with basic diseases or not, CURB score after admission and choose to use different kinds of antibiotics has nothing to do, not significant.4) In701cases of CAP patients,427cases of CAP patients conforms to in hospital standard, occupies all in hospital patients of67.4%, after in hospital, the CAP patient who follows the guide choice antibiotic has309examples, occupies all in hospital patients of43.9%.Conclusions1) Research demonstrated that the half of CAP patien achieves clinical stablity after72hours,. The factors that connected to clinical stability are:age、having complications、CURB score。2) Moxifloxacin is lower than β-lactam and macrolide in the adjust rates;the CAP patient prognosis only showed that with age related, is older, the treatment result is worse.3) The antibiatic chooses of initiate therapy are complicated; but part of chooses are not comply with guidelines.