Introduction

Compliance to community-acquired pneumonia (CAP) guideline has been shown to improve patients’ outcome and reduce healthcare cost. The compliance rate reported varies across the world but data in our region was severely lacking. We evaluated the compliance of CAP antibiotic guideline in a tertiary teaching hospital.

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Methods:

A retrospective study was undertaken in emergency department of University Malaya Medical Centre looking at subjects with a primary diagnosis of CAP from 1st January 2016 to 31st December 2016. Definition of CAP was based on international guidelines and stratified by severity score; CURB-65. A hospital based antibiotic guideline was used to assess level of compliance amongst physicians in CAP management.

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Results:

A total of 327 subjects were recruited and male predominates (173, 52.9%) with the mean age of 66.95 (±16.26). Majority had co-morbidities and hypertension was the commonest (188, 58.6%). Absolute compliance to guideline for regime, dose and route was seen in 28 (8.6%) subjects.

When stratified to CURB-65, a significant difference of compliance was seen (P< 0.001) with concordance rate was at its highest when subjects had moderate CAP (CURB-65 score = 2).

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Conclusion:

Our study showed that guideline compliance rate in the treatment of CAP was low. In view of the benefit of adherence to antibiotic guideline, ongoing education and more routine incorporation of the guideline in day to day practice among physicians are imperative.