Evidence map›Paper›PMID 30231869›Full record

ArticleBMC infectious diseases2018

Effects of a clinical pathway on antibiotic use in patients with community-acquired pneumonia: a multi-site study in China.

Liping Zhu, Jie Bai, Yongcong Chen, Di Xue

Abstract read
In one paragraph

Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Liping ZhuNHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Hospital Management, School of Public Health, Fudan University, Shanghai, People's Republic of China.
Jie BaiNHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Hospital Management, School of Public Health, Fudan University, Shanghai, People's Republic of China.
Yongcong ChenSchool of Public Health, Lanzhou University, Lanzhou, People's Republic of China.
Di XueNHC Key Laboratory of Health Technology Assessment (Fudan University), Department of Hospital Management, School of Public Health, Fudan University, Shanghai, People's Republic of China. xuedi@shmu.edu.cn.

Funding

National Natural Science Foundation of China 71473047
6 · The paper itself

Abstract

backgroundCommunity-acquired pneumonia (CAP) is a common condition with high mortality, morbidity and healthcare costs. This study aimed to determine whether clinical pathway (CP) implementation in different hospitals in China increased antibiotic compliance with the national CP in inpatients with CAP.

methodsChart reviews of CAP cases were conducted in 18 public hospitals from 3 different regions of China in 2015. Chi-square tests and the t-test were used to compare differences between hospitals that implemented CP (CP group) and those that did not (non-CP group). Multivariate logistic analysis was adopted to test whether CP implementation for CAP in hospitals affected their overall antibiotic use compliance rates with the national CP for CAP.

resultsThe overall compliance rate with the national CP for inpatients with CAP was 43.69%. The compliance rates for timely initial antibiotic use, recommended antibiotic use and use of the recommended combination of antibiotics and the overall compliance rate were substantially higher in the CP group than in the non-CP group. A multivariate logistic model for overall compliance in inpatients with CAP showed that the hospitals in the CP group had greater overall compliance than those in the non-CP group (odds ratio [OR] = 1.76; 95% confidence interval [CI] = 1.16-2.71) after controlling for hospital and inpatient characteristics.

conclusionIn China, the overall compliance rate with the national CP for inpatients with CAP was low, but inpatients with CAP in the hospitals in the CP group received antibiotics more concordantly with the national CP. Since adherence to evidence-based care has been shown to improve clinical outcomes, internal and external support from hospitals is required to facilitate CP implementation for inpatients with CAP. Additionally, governmental commitment, hospital input and population involvement are required to improve antibiotic utilization.

Indexed as

Critical PathwaysAnti-Bacterial AgentsChinaCommunity-Acquired InfectionsComorbidityFemaleHospitals, PublicHumansInpatientsMaleMiddle AgedMultivariate AnalysisPatient CompliancePneumoniaRetrospective StudiesAnti-Bacterial AgentsAntibioticClinical pathwayCommunity-acquired pneumoniaImplementation

Identifiers

PMID30231869
PMCPMC6146630

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.