Adults hospitalized are often inappropriately diagnosed and treated for pneumonia, a new study suggests.
According to a new study published in JAMA Internal Medicine, these misdiagnosed adults often receive entire courses of antibiotics that are not needed.
Among the elderly treated community-acquired pneumonia Researchers found that 12% of cases were misdiagnosed in hospitals.
Antibiotic resistance is on the rise, doctors warn: ‘This is a big problem’
The study also found that 88% of misdiagnosed patients received full antibiotic treatment, and 2% of them experienced side effects from the drug.
The Centers for Disease Control and Prevention (CDC) estimates that approximately 47 million antibiotics are prescribed annually in the United States for infections that do not require antibiotics.
Researchers found that 12% of elderly people treated in hospital for community-acquired pneumonia were misdiagnosed. (St. Petersburg)
Overuse of antibiotics can lead to resistance, which means bacteria become stronger and more resistant to the drug.
According to the CDC, more than 23,000 people die each year in the United States due to antibiotic resistance.
This can limit treatment options and make it more difficult for doctors to treat and cure the infection.
According to the CDC, more than 23,000 people die each year in the United States due to antibiotic resistance.
Main types of pneumonia
There are two main types of pneumonia: community-acquired and nosocomial.
community-acquired pneumonia (CAP) describes a type of pneumonia in patients who have not been recently hospitalized.
In these scenarios, patients develop a lung infection while in the community, according to the National Institutes of Health (NIH).
Overuse of antibiotics can lead to resistance, which means bacteria become stronger and more resistant to the drug. (St. Petersburg)
Nosocomial pneumonia occurs after a patient is admitted to a hospital.
People are not infected when they are first admitted to the hospital, but they become infected after being exposed to bacteria in the hospital.
Many patients with community-acquired pneumonia can be treated without being hospitalized.
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However, some CAP patients have serious medical problems or serious symptoms, are unable to eat or drink, are over 65 years of age, or are taking antibiotics but their symptoms do not improve. may require hospitalization, the NIH noted.
According to the CDC, CAP is one of the most common causes of hospitalization in the United States.
What we learned from the research
Researchers from the Veterans Affairs Ann Arbor Healthcare System and the University of Michigan Medical School, led by Michigan Health University Clinical Associate Professor and Principal Investigator Ashwin B. Gupta, M.D., examined patient records from the Michigan Hospital Medical Safety Consortium. did.Initiatives to improve Inpatient care.
The patients in the study were admitted for general treatment, but were later diagnosed with pneumonia and were treated with antibiotics on the first or second day of admission.
Researchers analyzed nearly 17,000 adults admitted to 48 Michigan hospitals from July 1, 2017 to March 31, 2020.
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The patients in the study were admitted for general treatment, but were later diagnosed with pneumonia and were treated with antibiotics on the first or second day of hospitalization.
Participants are considered “inappropriately diagnosed” if they have fewer than two symptoms of pneumonia or if their chest X-ray is negative for infection. (In other words, if she was diagnosed and she didn’t have the two symptoms or her x-rays were positive, then the diagnosis was wrong.)
The patients in the study were admitted for general treatment, but were later diagnosed with pneumonia and were treated with antibiotics on the first or second day of admission. (St. Petersburg)
This study found that inappropriate diagnosis of community-acquired pneumonia in hospitalized patients is common, especially among certain groups: senior citizen or those with dementia or altered mental status.
The researchers noted that patients with inappropriate diagnoses almost always received a full course of antibiotics.
Common symptoms
Experts say the classic diagnosis of pneumonia combines typical symptoms such as cough, fever, chills and shortness of breath with radiographic evidence from a chest X-ray.
Medical care is “overwhelmingly complex” for the elderly, experts say, “the hurdles are increasing”
X-rays are necessary because many of the symptoms can overlap with other conditions.
“For example, if you come to the hospital with a cough or shortness of breath, the list of possible etiologies is very extensive,” lead researcher Gupta told Fox News Digital in an email.
The classic diagnosis of pneumonia combines classic symptoms such as cough, fever, chills, and shortness of breath with radiographic evidence from a chest radiograph. (St. Petersburg)
“We find that people who are likely to have an underlying etiology other than pneumonia (such as congestive disease) are often heart failure) have been classified as having pneumonia and are being treated as such,” he continued.
“Inappropriate diagnosis and treatment of pneumonia can have repercussions, including a delay in understanding the practical problems and side effects associated with antibiotic treatment.”
The dangers of unnecessary antibiotics
“Inappropriate diagnosis is not benign,” the lead researcher warned.
“This means that understanding the underlying causes of a patient’s illness may be delayed or missed altogether.”
He added: “Antibiotic therapy is also not benign. Our study demonstrated that the entire duration of antibiotic therapy in this population is associated with antibiotic-related adverse events.”
“Inappropriate diagnosis means the underlying cause of a patient’s illness may be delayed or missed altogether.”
Outside experts have also warned of the risks.
“I think this study is alarming in that many patients (1 in 8, or more than 10%) receive an inappropriate diagnosis of pneumonia and receive a full course of treatment.” said Dr. Scott Roberts, associate medical director for infection prevention at Yale University. M.D. from New Haven, Conn., told Fox News Digital.
He was not involved in the study.
Common side effects of antibiotic use include an itchy, generalized rash. Nausea and diarrhea. Yeast infections, according to the CDC. (St. Petersburg)
“This is particularly problematic because the patient populations in which this is occurring are those most at risk for adverse events associated with antibiotic use.”
Professor Roberts stressed the need for healthcare professionals to accurately diagnose conditions before treating patients. full course of antibioticsthis may be unnecessary and may cause harmful side effects.
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Common side effects of antibiotics include an itchy rash all over the body. Nausea and diarrhea. Yeast infections, according to the CDC.
Serious side effects can include life-threatening allergic reactions and a bacterial infection called C. diff (Clostridioides difficile) that can cause severe colon damage and even death.
One doctor emphasized the need for health care workers to accurately diagnose the condition before administering a full course of antibiotics to a patient. (St. Petersburg)
“Diagnosis is difficult, and in general, health care providers are trying to provide the best care for their patients,” Dr. Gupta said.
“While we often think about the problems associated with underdiagnosis of symptoms (such as missed infections), there are real risks to inappropriate diagnosis,” he said.
Research limitations
The researchers noted that the researchers may have underestimated the number of patients who were inappropriately diagnosed because the signs and symptoms of pneumonia overlap considerably with other diseases.
The study was also not designed to assess “causality,” Gupta noted.
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“Thus, although we can say that there is an association between the total duration of antibiotic treatment and antibiotic-related adverse events, we cannot say that the total duration of antibiotic treatment caused antibiotic-related adverse events. No,” he continued.
“We hope that this study provides a framework by which healthcare providers, hospitals, and health systems can adjust the accuracy of pneumonia diagnosis in hospitalized patients,” he said.
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