Abstract
BACKGROUND:
CAP is a major burden with high prevalence and significant mortality and morbidity.Current evidences suggest that treatment of low risk patients in community is safe and reduce health costs by minimizing unnecessary hospital admissions and GPs can play an important role in primary care.
OBJECTIVE:
Our aim was to assess, at a community level, GPs knowledge about CAP and their assessment and prescription pattern.
METHODOLOGY:
A multicentre cross sectional survey was done in 10 cities of Pakistan from November 2011 to January 2012. A total of 110 GPs were recruited,with minimum of 3 years experience, and were not engaged with University teaching or research.Convenient sampling was done and data was collected on structured questionnaire.
RESULTS:
71% of GPs reported to work in high prevalence areas for respiratory ailments. Diagnosis of CAP was relied on physical examination in less than 5% of cases.
58% of GPs used PSI and 38% CURB 65 for assessment of severity but it was alarming to note that only 58% intend to treat severe pneumonia with IV antibiotics and there was reluctance for referral to hospital.
The majority(70%) of GPs claimed awareness of recent guidelines of CAP but the antibiotic class most prevalently used was oral macrolide(54%) in mild, oral quinolones(40%) in moderate and combinations of non antipseudomonal cephalosporin+Macrolide(55%) in severe cases.
CONCLUSION:
The major problems encountered were late referral of patients to hospital, poor knowledge of recent guidelines and prescription of inadequate regimens that in turn can lead to high mortality and morbidity and emergence of resistant bacteria as cause of CAP.
- © 2012 ERS