Assessment of Clinical Guideline Adherence in the Inpatient Management of Uncomplicated Pneumonia: A Descriptive Observational Study

Abstract

Introduction: Community-acquired pneumonia represents a frequent cause of pediatric hospitalization, with predominantly viral etiology in children under five years. In Chile, Streptococcus pneumoniae is the most common bacterial agent, with low resistance to penicillin. Clinical guidelines recommend the use of narrow-spectrum antibiotics; however, variability in clinical practice persists.  

Objective: To evaluate compliance with care standards for inpatient management of uncomplicated pneumonia, according to IDSA (2011) recommendations, in pediatric patients hospitalized between January 2021 and December 2023. Patients and Method: Descriptive observational study based on review of medical records of 106 patients hospitalized for uncomplicated community-acquired pneumonia at Hospital Clínico de la Universidad Católica, Santiago, Chile.  

Results: A total of 106 patients were analyzed, with a mean age of 3.8 years; 51% were female. The main risk factors were asthma (30%), prematurity (19.8%) and respiratory history (26%). 82% required oxygen on admission. Regarding antibiotic treatment, 47% received narrow-spectrum antibiotics and 53% broad-spectrum. No significant differences were found in length of hospitalization or ICU admission between both groups (p = 0.688).  

Conclusions: The results show opportunities for improvement in adherence to international guidelines, as well as high use of complementary tests. A justified use of macrolides was observed.