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Practice Patterns For Antibiotic De-Escalation In Culture-Negative Healthcare-Associated Pneumonia, M. Schlueter, C. James, A. Dominguez, Laura V. Tsu, G. Seymann

Pharmacy Faculty Articles and Research

Background Published guidelines for the treatment of healthcare-associated pneumonia (HCAP) recommend initial broad-spectrum antibiotics with appropriate de-escalation based on culture results. Guideline recommendations are based on data from intubated patients, in whom cultures are easily obtained. The approach to antibiotic de-escalation for culture-negative patients has not been addressed. Consequently, there are no published reports that describe the current standard of practice. Patients and methods All patients admitted to a university hospital with a diagnosis of HCAP, as defined by use of a pneumonia orderset, were identified retrospectively over a 2-year period. Antibiotics prescribed on admission, during hospital stay, and on …