Compliance with guidelines for the management of community acquired pneumonia at primary health care centers

Background: Community acquired pneumonia (CAP) has a high mortality rate among older people. To increase its treatment efficiency, the Chilean Ministry of Health elaborated a clinical management guideline for CAP Aim: To assess The degree of compliance with the CAP among professionals working at primary health care centers. Material and methods: A follow up of a cohort of 2,797 subjects aged 67 years or more incorporated to a clinical study. All cases of bronchopneumonia or pneumonia diagnosed at primary of health care centers between September 2005 and June 2008, were recorded. Results: During the follow up period, 192 cases of CAP were diagnosed. A chest X ray was requested in 8.1% of cases and a confirmation consultation was done in 58%. Amoxicillin/Clavulanic acid was the most common antimicrobial prescription in 61% of cases, followed by clarithromycin in 17% and Amoxicillin in 12%. The antimicrobial used was not registerd in 5% of cases. Conclusions: The clinical guidelines improve the efficiency of CAP treatment and decrease complications. However, these guidelines must be complemented with an adequate training and supervision of health care teams (Rev Med Chile 2009; 137: 1575-82).