Impact of Comprehensive Education on Antibiotic Duration of Therapy for Community-Acquired Pneumonia in a Community Hospital

Abstract

Background:

In 2019, the Infectious Diseases Society of America (IDSA) released updated guidelines for the treatment of community-acquired pneumonia (CAP). These guidelines recommend a new preferred duration of therapy of no less than a total of five days if the patient has achieved clinical stability. This quality improvement project will determine whether comprehensive education to pharmacists and providers impacts the total duration of antibiotic therapy for patients treated for CAP.

Objectives:

The primary endpoint was to evaluate the impact of the intervention on antibiotic duration of therapy for patients with CAP in the post-intervention group. The secondary endpoints were the impact on duration of therapy for patients with an antibiotic switch or patients with an outpatient prescription for antibiotics for CAP at discharge.

Methods:

This study was an IRB-approved, retrospective cohort study. Education was provided to clinical pharmacists during scheduled monthly meetings for a 6-month period starting in August 2024. Hospitalists were educated in a separate meeting prior to post-intervention data collection. Data were collected from February 1, 2024 to July 31, 2024 and September 1, 2024 to February 28, 2025 for the pre- and post-intervention cohorts, respectively.

Results:

The pre- and post-intervention cohorts include 116 and 145 patients, respectively. Total duration of therapy decreased by 0.9 days after the intervention (7.3 ± 2.7 and 6.4 ± 2 days, respectively, in the pre- and post-intervention groups; P = .005). Duration of therapy decreased by 1 day for patients with an antibiotic switch after the intervention (seven days [6-10] and six days [5-8] in the pre- and post-intervention groups, respectively; P < .001). Duration of therapy for patients with an outpatient antibiotic prescription decreased by 1.5 days after the intervention (8.8 ± 3 and 7.3 ± 2.3 days, respectively, in the pre- and post-intervention groups; P < .01).

Conclusions:

The pharmacist-led education resulted in a statistically significant reduction in the duration of therapy for patients treated for CAP. There was a statistically significant reduction in the duration of therapy after the intervention in patients who had an antibiotic switch and those who had an outpatient antibiotic prescription for CAP at discharge.