Retrospective analysis of discharge antibiotic selection and 30-day readmission rate for community acquired pneumonia

Abstract

Purpose

This study evaluates 30-day community-acquired pneumonia (CAP) readmission rates dependent on discharge antibiotic selection.

Patients and methods

This is a retrospective, single-center, observational study of patients discharged with a diagnosis of CAP from July 1st, 2022 through June 30th, 2023. Patients included those empirically treated with ceftriaxone plus azithromycin and with documentation of discharge antibiotics.

Results

Beta-lactam combination therapy represented the most frequent discharge antibiotic regimen (n = 161). Only 6/368 patients were re-admitted within 30 days. No significant difference was detected in readmission rates between beta-lactam and non-beta-lactam monotherapy (p = 0.921), or between combination therapy and monotherapy (p = 0.604). The average total duration of combined inpatient (4 days) and outpatient (5 days) antibiotic therapy was 9 days.

Conclusion

Broad-spectrum or combination antibiotic therapy at discharge did not result in lower readmission rates. The significant antibiotic stewardship opportunities that remain at transition from in-patient to out-patient care should prioritize narrow spectrum, short-course, monotherapy antibiotic regimens when the causative pathogen is unknown.