Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients

Sandra L. Kane-Gill, Keith M. Olsen, Jill A. Rebuck, Rhonda S. Rea, D. Wesston Boatwright, Maureen A. Smythe, Terrence R. Walker, Stephanie L. Lager, Tudy Hodgman

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Aspiration syndromes (pneumonia and pneumonitis) have significantly different processes. An evaluation of treatment and outcomes for these different syndromes has not been reported previously. OBJECTIVE: To characterize and assess antimicrobial prescribing patterns for aspiration syndromes in intensive care unit (ICU) patients and describe outcomes of those patients. METHODS: A retrospective, observational evaluation was conducted using a convenience sample of patients at 27 hospitals in North America; these patients were admitted to an adult ICU with a diagnosis of suspected/confirmed aspiration or had a suspected/confirmed aspiration while in the ICU. Hospital demographic, diagnosis, treatment, and clinical outcome data were collected. RESULTS: Over a 12 month period, 187 patients were observed. Aspiration syndromes included suspected aspiration (31%; n = 58), aspiration pneumonitis (12%; n = 23), aspiration pneumonia (55%; n = 103), and diagnosis not available (1.6%; n = 3). Antimicrobial management for the aspiration syndromes was as follows: suspected aspiration: 59% single agent, 38% multiple agents, and 3% no therapy; aspiration pneumonitis: 48% single agent, 39% multiple agents, and 13% no therapy; aspiration pneumonia: 48% single agent, 52% multiple agents, and 0% no therapy. Antimicrobial therapy was prescribed in patients with suspected (97%) and confirmed (100%) aspiration. Antibiotic therapy duration was significantly longer tor aspiration pneumonia (9.1 ± 7.5 days) than for aspiration pneumonitis (5.2 ± 3.6 days; p = 0.013). Length of ICU stay was similar across patient groups. CONCLUSIONS: Antimicrobial agents are frequently prescribed to treat aspiration syndromes despite the lack of demonstrated efficacy for aspiration pneumonitis. Outcomes between aspiration syndromes were similar with the exception of duration of antibiotic treatment.

Original languageEnglish (US)
Pages (from-to)549-555
Number of pages7
JournalAnnals of Pharmacotherapy
Volume41
Issue number4
DOIs
StatePublished - Apr 1 2007

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Critical Illness
Aspiration Pneumonia
Pneumonia
Intensive Care Units
Therapeutics
Anti-Bacterial Agents
North America
Anti-Infective Agents
Demography

Keywords

  • Aspiration syndromes
  • Critically ill
  • Intensive care unit
  • Pneumonia
  • Pneumonitis

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Kane-Gill, S. L., Olsen, K. M., Rebuck, J. A., Rea, R. S., Boatwright, D. W., Smythe, M. A., ... Hodgman, T. (2007). Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients. Annals of Pharmacotherapy, 41(4), 549-555. https://doi.org/10.1345/aph.1H675

Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients. / Kane-Gill, Sandra L.; Olsen, Keith M.; Rebuck, Jill A.; Rea, Rhonda S.; Boatwright, D. Wesston; Smythe, Maureen A.; Walker, Terrence R.; Lager, Stephanie L.; Hodgman, Tudy.

In: Annals of Pharmacotherapy, Vol. 41, No. 4, 01.04.2007, p. 549-555.

Research output: Contribution to journalArticle

Kane-Gill, SL, Olsen, KM, Rebuck, JA, Rea, RS, Boatwright, DW, Smythe, MA, Walker, TR, Lager, SL & Hodgman, T 2007, 'Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients', Annals of Pharmacotherapy, vol. 41, no. 4, pp. 549-555. https://doi.org/10.1345/aph.1H675
Kane-Gill SL, Olsen KM, Rebuck JA, Rea RS, Boatwright DW, Smythe MA et al. Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients. Annals of Pharmacotherapy. 2007 Apr 1;41(4):549-555. https://doi.org/10.1345/aph.1H675
Kane-Gill, Sandra L. ; Olsen, Keith M. ; Rebuck, Jill A. ; Rea, Rhonda S. ; Boatwright, D. Wesston ; Smythe, Maureen A. ; Walker, Terrence R. ; Lager, Stephanie L. ; Hodgman, Tudy. / Multicenter treatment and outcome evaluation of aspiration syndromes in critically ill patients. In: Annals of Pharmacotherapy. 2007 ; Vol. 41, No. 4. pp. 549-555.
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abstract = "BACKGROUND: Aspiration syndromes (pneumonia and pneumonitis) have significantly different processes. An evaluation of treatment and outcomes for these different syndromes has not been reported previously. OBJECTIVE: To characterize and assess antimicrobial prescribing patterns for aspiration syndromes in intensive care unit (ICU) patients and describe outcomes of those patients. METHODS: A retrospective, observational evaluation was conducted using a convenience sample of patients at 27 hospitals in North America; these patients were admitted to an adult ICU with a diagnosis of suspected/confirmed aspiration or had a suspected/confirmed aspiration while in the ICU. Hospital demographic, diagnosis, treatment, and clinical outcome data were collected. RESULTS: Over a 12 month period, 187 patients were observed. Aspiration syndromes included suspected aspiration (31{\%}; n = 58), aspiration pneumonitis (12{\%}; n = 23), aspiration pneumonia (55{\%}; n = 103), and diagnosis not available (1.6{\%}; n = 3). Antimicrobial management for the aspiration syndromes was as follows: suspected aspiration: 59{\%} single agent, 38{\%} multiple agents, and 3{\%} no therapy; aspiration pneumonitis: 48{\%} single agent, 39{\%} multiple agents, and 13{\%} no therapy; aspiration pneumonia: 48{\%} single agent, 52{\%} multiple agents, and 0{\%} no therapy. Antimicrobial therapy was prescribed in patients with suspected (97{\%}) and confirmed (100{\%}) aspiration. Antibiotic therapy duration was significantly longer tor aspiration pneumonia (9.1 ± 7.5 days) than for aspiration pneumonitis (5.2 ± 3.6 days; p = 0.013). Length of ICU stay was similar across patient groups. CONCLUSIONS: Antimicrobial agents are frequently prescribed to treat aspiration syndromes despite the lack of demonstrated efficacy for aspiration pneumonitis. Outcomes between aspiration syndromes were similar with the exception of duration of antibiotic treatment.",
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AU - Boatwright, D. Wesston

AU - Smythe, Maureen A.

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N2 - BACKGROUND: Aspiration syndromes (pneumonia and pneumonitis) have significantly different processes. An evaluation of treatment and outcomes for these different syndromes has not been reported previously. OBJECTIVE: To characterize and assess antimicrobial prescribing patterns for aspiration syndromes in intensive care unit (ICU) patients and describe outcomes of those patients. METHODS: A retrospective, observational evaluation was conducted using a convenience sample of patients at 27 hospitals in North America; these patients were admitted to an adult ICU with a diagnosis of suspected/confirmed aspiration or had a suspected/confirmed aspiration while in the ICU. Hospital demographic, diagnosis, treatment, and clinical outcome data were collected. RESULTS: Over a 12 month period, 187 patients were observed. Aspiration syndromes included suspected aspiration (31%; n = 58), aspiration pneumonitis (12%; n = 23), aspiration pneumonia (55%; n = 103), and diagnosis not available (1.6%; n = 3). Antimicrobial management for the aspiration syndromes was as follows: suspected aspiration: 59% single agent, 38% multiple agents, and 3% no therapy; aspiration pneumonitis: 48% single agent, 39% multiple agents, and 13% no therapy; aspiration pneumonia: 48% single agent, 52% multiple agents, and 0% no therapy. Antimicrobial therapy was prescribed in patients with suspected (97%) and confirmed (100%) aspiration. Antibiotic therapy duration was significantly longer tor aspiration pneumonia (9.1 ± 7.5 days) than for aspiration pneumonitis (5.2 ± 3.6 days; p = 0.013). Length of ICU stay was similar across patient groups. CONCLUSIONS: Antimicrobial agents are frequently prescribed to treat aspiration syndromes despite the lack of demonstrated efficacy for aspiration pneumonitis. Outcomes between aspiration syndromes were similar with the exception of duration of antibiotic treatment.

AB - BACKGROUND: Aspiration syndromes (pneumonia and pneumonitis) have significantly different processes. An evaluation of treatment and outcomes for these different syndromes has not been reported previously. OBJECTIVE: To characterize and assess antimicrobial prescribing patterns for aspiration syndromes in intensive care unit (ICU) patients and describe outcomes of those patients. METHODS: A retrospective, observational evaluation was conducted using a convenience sample of patients at 27 hospitals in North America; these patients were admitted to an adult ICU with a diagnosis of suspected/confirmed aspiration or had a suspected/confirmed aspiration while in the ICU. Hospital demographic, diagnosis, treatment, and clinical outcome data were collected. RESULTS: Over a 12 month period, 187 patients were observed. Aspiration syndromes included suspected aspiration (31%; n = 58), aspiration pneumonitis (12%; n = 23), aspiration pneumonia (55%; n = 103), and diagnosis not available (1.6%; n = 3). Antimicrobial management for the aspiration syndromes was as follows: suspected aspiration: 59% single agent, 38% multiple agents, and 3% no therapy; aspiration pneumonitis: 48% single agent, 39% multiple agents, and 13% no therapy; aspiration pneumonia: 48% single agent, 52% multiple agents, and 0% no therapy. Antimicrobial therapy was prescribed in patients with suspected (97%) and confirmed (100%) aspiration. Antibiotic therapy duration was significantly longer tor aspiration pneumonia (9.1 ± 7.5 days) than for aspiration pneumonitis (5.2 ± 3.6 days; p = 0.013). Length of ICU stay was similar across patient groups. CONCLUSIONS: Antimicrobial agents are frequently prescribed to treat aspiration syndromes despite the lack of demonstrated efficacy for aspiration pneumonitis. Outcomes between aspiration syndromes were similar with the exception of duration of antibiotic treatment.

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KW - Critically ill

KW - Intensive care unit

KW - Pneumonia

KW - Pneumonitis

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