Cumplimiento de la guía clínica de manejo ambulatorio de la neumonía adquirida en la comunidad en personas mayores en centros de atención primaria de salud de Santiago

Background: Community acquired pneumonia (CAP) has a high mortality rate among older people. To increase its treatment efficiency, the Chilean Ministry of Health elaborated a clinical management guideline for CAP. Aim: To assess the degree of compliance with the clinical guidelines for CAP among professionals working at primary health care centers. Material and methods: A follow up of a cohort of 2,797 subjects aged 67 years or more, incorporated to a clinical study. All cases of bronchopneumonia or pneumonia diagnosed at primary health care centers between September 2005 and June 2008 were recorded. Results: During the follow up period, 192 cases of CAP were diagnosed. A chest X-ray was requested in 81% of cases and a confirmation consultation was done in 58%. Amoxicillin/ Clavulanic acid was the most common antimicrobial prescription in 61% of cases, followed by Clarithromycin in 17% and Amoxicillin in 12%. The antimicrobial used was not registered in 5% of cases. Conclusions: The clinical guidelines improve the efficiency of CAP treatment and decrease complications. However, these guidelines must been complemented with an adequate training and supervision of health care teams.