Management of community acquired pneumonia by Family Physicians

Background and Objective: Community Acquired Pneumonia (CAP) is a major burden on health system with significant mortality and morbidity. Family Physicians (FPs) can play important role. To determine management strategies and prescription of FPs regarding CAP.

Methods: A multicenter cross sectional survey was done in 10 cities of Pakistan from November 2014 to January 2015. Self-administered questionnaire was filled by 110 Family Physicians.

Results: Of total 71% of FPs reported to work in high prevalence areas for respiratory ailments. Only 32% of FPs used PSI and 34% CURB 65 for assessment of severity. It was alarming to note that only 58% of FPs treats severe pneumonia with Intravenous antibiotics while rests were comfortable with oral route. The overall use of quinolones to treat CAP, irrespective of severity, in combination or as single agent was > 60%. Duration of antibiotics for severe pneumonia was sub optimal (<10 days). Only 52.8% patients came back for follow-up so true outcome cannot be anticipated.

Conclusion: Major deficiencies were treatment of severe pneumonia in community, inappropriate use of quinolones and poor knowledge of recent guidelines. This can lead to emergence of resistant bacteria and high mortality and morbidity.