NEW YORK (Reuters Health) - The severity of illness and the mortality rate in people with pneumonia resulting from a recent outpatient contact with the health care system is higher than pneumonia acquired in the community setting, physicians in Italy report.

The worse outcomes seem to be tied to treatment with inappropriate antibiotics, the investigators report in the Annals of Internal Medicines.

Dr. Mario Venditti at the University of Rome and his associates compared outcomes for 362 patients treated at 55 hospitals in 2007 for pneumonia that was acquired in the community, the hospital, or other health care settings.

Compared with community-acquired disease, pneumonia associated with outpatient health care was more severe, required longer hospital stays, and had higher fatality rates (17.8 percent vs 6.7 percent). The mortality rate with hospital-acquired pneumonia was even higher, at 18.4 percent.

The investigators observed that less than 30 percent of patients with health care-associated pneumonia were given recommended antibiotic therapy compared with 60 percent to 70 percent of the other groups.

To improve outcomes of health care-associated pneumonia, Venditti's group recommends that antibiotics should be able to knockout methicillin-resistant Staphylococcus aureus, or MRSA, and other multidrug-resistant organisms.

SOURCE: Annals of Internal Medicine, January 6, 2009.

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