Antibiotics often prescribed despite negative chest X-rays in pneumonia cases

December 6, 2024

Study design: This prospective cross-sectional study conducted in France from November 2017 to December 2019 involved 259 adult patients with clinically suspected community-acquired pneumonia (CAP). Primary care physicians (PCPs) enrolled patients and performed chest radiograph (CR) within 6 hours of initial consultation. CR results were categorized as positive or negative for CAP, and antibiotic initiation was recorded.

Results: Among the 259 patients, 144 (55.6%) had positive CR results. Antibiotics were initiated in 99.3% of patients with positive CR and 68.7% of those with negative CR (P < .001). Clinical severity and symptom duration were greater in patients with positive CR. However, clinical characteristics didn’t significantly differ between CR-negative patients who received antibiotics and those who didn’t.

Impact on clinical practice: The study highlights a discrepancy between guideline recommendations and actual practice, with PCPs frequently prescribing antibiotics even when CR results are negative. This underscores the need for clearer guidelines on managing suspected CAP without radiologic confirmation to reduce unnecessary antibiotic use and combat antimicrobial resistance.

Source:

Pinot J, et al. (2024, November-December). Ann Fam Med. Relation Between Chest Radiography Results and Antibiotic Initiation in Community-Acquired Pneumonia Management by General Practitioners. https://pubmed.ncbi.nlm.nih.gov/39586692/