Associations Between Initial Antimicrobial Therapy and Medical Outcomes for Hospitalized Elderly Patients With Pneumonia

Abstract
EACH YEAR in the United States approximately 4 million adults develop pneumonia, of whom more than 1 million patients are hospitalized.1-4 In 1993, in-hospital mortality for pneumonia among patients older than 65 years was 10.7 deaths per 100 discharges, and in that year alone $3.5 billion was spent on inpatient care of Medicare patients with this illness.5 Because of the substantial mortality of pneumonia, particularly among the elderly, it is essential that initial antimicrobial therapy have activity against the causative organism(s). Unfortunately, the causative organism(s) are often unknown at the time antimicrobial therapy is initiated; bacteriological culture results and other microbiological studies are positive in less than 50% of hospitalized patients, even in carefully conducted prospective studies of pneumonia etiology.6-9

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