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Audit, research and guideline update
Time to first antibiotic and mortality in adults hospitalised with community-acquired pneumonia: a matched-propensity analysis
  1. Priya Daniel1,
  2. Chamira Rodrigo1,
  3. Tricia M Mckeever2,
  4. Mark Woodhead3,
  5. Sally Welham4,
  6. Wei Shen Lim1
  7. on behalf of the British Thoracic Society
  1. 1Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
  3. 3Department of Respiratory Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  4. 4British Thoracic Society, London, UK
  1. Correspondence to Dr Priya Daniel, Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, David Evans Building, City Hospital Campus, Hucknall Road, Nottingham NG51PB, UK; priyasosha.daniel{at}


A matched-propensity analysis of national data from the British Thoracic Society community-acquired pneumonia audit was conducted (n=13 725). Overall, time to first antibiotic (TFA) was ≤4 h in 63%. Adjusted 30-day inpatient (IP) mortality was lower for adults with TFA ≤4 h compared with TFA >4 h (adjusted OR 0.84, 95% CI 0.74 to 0.94; p=0.003). Increasing TFA was associated with greater OR of 30-day IP mortality (p value for trend=0.001), but no TFA threshold was evident. Although we found an association between TFA and mortality, we cannot say whether this is causal or whether TFA might just be a quality measure for overall or other processes of care.

  • Pneumonia

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