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Clinical pathway and monthly feedback improve adherence to antibiotic guideline recommendations for community-acquired pneumonia

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posted on 2023-05-18, 21:11 authored by Almatar, M, Gregory PetersonGregory Peterson, Angus ThompsonAngus Thompson, McKenzie, D, Anderson, T, Syed Razi ZaidiSyed Razi Zaidi
Background: Compliance with community-acquired pneumonia (CAP) guidelines remains poor despite a substantial body of evidence indicating that guideline-concordant care improves patient outcomes. The aim of this study was to compare the relative effectiveness of a general educational and a targeted emergency department intervention on improving physicians’ concordance with CAP guidelines.

Methods: Two distinct interventions were implemented over specific time periods. The first intervention was educational, focusing on the development of local CAP guidelines and their dissemination through hospital-wide educational programmes. The second intervention was a targeted one for the emergency department, where a clinical pathway for the initial management of CAP patients was introduced, followed by monthly feedback to the emergency department (ED) physicians about concordance rates with the guidelines. Data on the concordance rate to CAP guidelines was collected from a retrospective chart review.

Results: A total of 398 eligible patient records were reviewed to measure concordance to CAP guidelines over the study period. Concordance rates during the baseline and educational intervention periods were similar (28.1% vs. 31.2%; p > 0.05). Significantly more patients were treated in accordance with the CAP guidelines after the ED focused intervention when compared to the baseline (61.5% vs. 28.1%; p < 0.05) or educational period (61.5% vs. 31.2%; p < 0.05).

Conclusions: A targeted intervention with a CAP clinical pathway and monthly feedback was a successful strategy to increase adherence to empirical antibiotic recommendations in CAP guidelines.


Publication title

PLoS One





Article number









School of Pharmacy and Pharmacology


Public Library of Science

Place of publication

United States

Rights statement

Copyright The Authors Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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