Article Text


Clinical challenges in diagnosing and managing respiratory infection
P243 Duration and choice of antibiotics in hospital admitted community acquired pneumonia patients over a period of 5 years in NHS South East of Scotland
  1. G C Choudhury,
  2. P M Mandal,
  3. A A Akram,
  4. A S Singanayagam,
  5. J C Chalmers,
  6. A H Hill
  1. Royal Infirmary of Edinburgh, Edinburgh, UK


Introduction Clostridium difficile infection is associated with class of antibiotics as well as the duration of treatment. The aim of this study was to ascertain if the rate of hospital related Clostridium difficile varied with the duration and choice of antibiotics in those admitted to hospital with Community Acquired Pneumonia (CAP) over a period of 5 years (2005–2009).

Methods As a part of a prospective observational study of CAP in NHS Lothian, we investigated the duration and choice of antibiotics in hospital admitted CAP and the rate of Clostridium difficile infection in these patients over a period of 5 years (2005–2009). For multiple comparisons, we used the Kruskal–Wallis test for numerical data and Chi squared test for the categorical data.

Results The duration and choice of antibiotics are tabulated in the Abstract P243 Table 1. The length of antibiotics used for severe CAP was therefore, longer than mild CAP. The duration of antibiotics for all severity of CAP, has not changed between 2005 and 2009. There has been a reducing usage of cephalosporins and macrolides with rising use of co-amoxiclav. The contribution of CAP as a cause for Clostridium difficile, however, remains unchanged.

Abstract P243 Table 1

Change in components of the NHP and LCQ

Conclusion In conclusion our study shows that the proportion of Clostridium difficile cases due to CAP has not changed in NHS Lothian between 2005 and 2009, despite significant reduction of cephalosporins and macrolide use. Randomised controlled trials are needed to assess whether reducing the length of treatment will influence Clostridium difficile rates.

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