Community-Acquired pneumonia in outpatients: etiology and outcomes.
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Community-Acquired pneumonia in outpatients: etiology and outcomes.
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Authors: Cillóniz C Ewig S Polverino E Marcos MA Prina E Sellares J Ferrer M Ortega M Gabarrús A Mensa J Torres A
Address: Institut del Tórax, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
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The purpose of this study was to establish the microbial etiology and outcomes of patients with Community-Acquired pneumonia (CAP) treated as outpatients after presenting to a hospital emergency care unit.Prospective observational study carried out in the Hospital Clinic of Barcelona Spain. All consecutive cases of CAP treated as outpatients were included.568 adult outpatients with CAP were studied, mean ±SD age of 47.2±17.6 years; 110 (19.4%) were aged ≥65 years. Etiologic diagnoses were established in 188 cases (33.1%). Streptococcus pneumoniae was the most frequent pathogen followed by Mycoplasma pneumoniae and respiratory viruses. Legionella was detected in 2.3% (n=13). More than one causative agent was found in 17 (9.0%) patients.The mortality was low (3; 0.5%), and other adverse events were rare (complications (30, 5.3%), readmission (13, 2.3%), treatment failure (13, 2.3%). Complications were mostly related to pleural effusion and empyema and readmissions and treatment failures to comorbidities.Outpatients with CAP have a characteristic microbial pattern. Regular anti-pneumococcal coverage remains mandatory. Treatment failures and readmissions are rare and may be reduced by increased attention to patients requiring short term observation in the emergency care unit and in the presence of pleural effusion and comorbidities.
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