Investigation of antimicrobial therapy for aspiration pneumonia in elderly nursing homes: a retrospective observational study in Japan

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Yuji Nakagawa
Hideo Kato
Takuya Iwamoto


Aspiration pneumonia, Elderly nursing home, Practice guidelines, Japan


Objective: Poor prognostic factors in the treatment of infectious diseases in home care have not been studied to date. Further, there have been no studies on the appropriate use of antimicrobial agents for aspiration pneumonia in elderly nursing home. Therefore, this study was retrospectively investigated the status of antimicrobial use for aspiration pneumonia in elderly nursing homes, and the clinical efficacy of each antimicrobial therapy. Methods: Patients who received antimicrobial therapy for aspiration pneumonia between 2020 and 2022 were included. This study was investigated the compliance of antimicrobial therapy with recommended Japanese guidelines. The clinical efficacy and safety of the recommended and non-recommended antimicrobial therapies were examined. Results: Fifty patients with aspiration pneumonia were administered antimicrobials. The rate of compliance to the guidelines for the appropriate selection, dose, and duration of antimicrobials were 46%, 66%, and 66%. This investigation indicated that all three indicators were appropriate showed a higher clinical cure rate and lower mortality rate than those in groups for which all three indicators were inadequate (clinical cure, 91.7% vs. 0%, p = 0.008; 30-days mortality, 8.3% vs. 33.3%, p = 0.371). In addition, appropriate drug selection resulted in lower mortality, and appropriate dosing duration was significantly associated with better clinical cure rates (p<0.0001). Conclusions: Overall, the appropriate use of antimicrobials according to the guidelines appears to be associated with improved clinical outcomes in the treatment of aspiration pneumonia in elderly nursing homes

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