Background: Hospital Acquired Pneumonia is the second1 most common nosocomial infection. Although HAP is not a reportable illness, available data suggest that it occurs at a rate of between 5 and 10 cases per 1,000 hospital admissions. The recent American Thoracic Society Guidelines2 practicing physician, treatment according to the local epidemiology, etiology and resistance patterns recorded per hospital is still considered for the management of HAP serves as a framework for the practicing physician, treatment according to the local epidemiology, etiology and resistance patterns recorded per hospital is still considered.
Objectives: The aim of this study is to determine the effectiveness of the Clinical Practice Guidelines compliance on the outcome of patients who developed Hospital Acquired Pneumonia in the Philippine Heart Center and to determine the incidence of HAP.
Methods: All admitted adult patients were recruited once they meet the inclusion/exclusion criteria. Informed consent will be obtained from all subjects. Age, sex, smoking history, co-morbidities were obtained. Subjects were assessed daily from the 3rd hospital day until discharge. They were assessed for the development of HAP. Compliance for the management of HAP using a checklist was determined. Included in the checklist are: Sputum GS/CS, Blood CS, CBC, and CXR, use of appropriate antibiotics based on CPG. A score of 6 means good compliance while a score of of <5 means poor compliance.
Results: There were a total of 312 patients who developed hospital acquired pneumonia in this study. 190 were male and 122 were female. Mean age of the population with good outcome was 67 years old while 64 years old in those who had poor outcome. Among the accompanying co-morbidities, cardiac disease predominated the population study. The most common isolate in the blood and sputum culture of the subjects was Klebsiella pneumonia and Meropenem was the frequent antibiotic used. One hundred forty two patients were managed by the attending physician based on the CPC Guidelines of these, 94 (54.97) had good outcome while 48 had poor outcome. The odds ratio of 2.33 signify that there is better outcome if attending physician adhere to the CPC Guidelines
Conclusion: Compliance with CPG is associated with better outcome. Attending physician should comply on the CPG guidelines on the management of HAP to attain better outcome for patients' over-all well being and longevity of life.