Abstract:
Pneumonia is the leading cause of morbidity and mortality among all age groups
throughout the world, especially in low and middle-income countries. The empiric approach of
treating hospitalized patients with pneumonia is common in our country despite the high
prevalence of drug-resistant pathogens. In this respect, it is inevitable to know the appropriateness
and outcomes of antimicrobial treatments for patients with pneumonia.
Objective: To assess appropriateness, outcomes of antimicrobial treatments, and associated
factors among patients with pneumonia at medical and pediatric wards of Hiwot Fana Specialized
University Hospital and Jugal Hospital from May 1-31, 2021.
Method and Materials: A retrospective cross-sectional study was conducted among 693 patients
with pneumonia admitted to medical and pediatric wards of Hiwot Fana Specialized University
Hospital and Jugal Hospital from May 1-31, 2021. Data were extracted from patient medical record
cards. Then, entered into EpiData version 3.1 and analyzed with SPSS version 26. Bivariable and
multivariable logistic regression was run to identify factors associated with unfavorable treatment
outcome. The model goodness of fit was checked by the Hosmer-Lemeshow statistic test.
Association was described using adjusted odds ratio along with 95% confidence interval and P value <0.05 was considered as a statistically significant association.
Results: From a total of 693 patients included, 88 (12.7%, 95%, CI:10.2-15.2) of them had
unfavorable treatment outcome. Ceftriaxone plus azithromycin followed by ceftriaxone alone were
the most commonly used antimicrobials in the treatment of pneumonia. A total of 116 (16.74%)
of patients had received initial inappropriate treatments. Patients with comorbidity (AOR=2.96;
95%, CI:1.47-5.97), abnormal body temperature (AOR=4.03; 95%, CI:2.14-7.58), tachycardia
(AOR=2.57; 95%, CI:1.45-4.55), bradypnea or tachypnea (AOR=3.92; 95%, CI:1.94-7.92),
oxygen saturation < 90% (AOR=2.52; 95%, CI:1.37-4.64), leukocytosis (AOR=2.78, 95%,
CI:1.38-5.58), and initial inappropriate treatments (AOR=4.30; 95%, CI:2.33-7.94) were
significantly associated with unfavorable treatment outcome.
Conclusion: More than one in ten patients and one in five patients had unfavorable treatment
outcome and received initial inappropriate treatments respectively. Hence, adherence to the
recommendation of guidelines and giving special attention to patients with comorbidity and
abnormal vital signs can help for optimal treatment of patients with pneumonia
