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Hospitalized patients with misdiagnosed community-acquired pneumonia (CAP) often are treated inappropriately with antibiotics. This process can delay correct treatment of alternative conditions, cause antibiotic-associated adverse events and antibiotic resistance, and increase costs.
In this prospective cohort study of 17,000 patients in 48 Michigan hospitals whose discharge diagnoses included CAP, 12% of patients had inappropriate diagnoses (i.e., <2 signs/symptoms of CAP or negative chest imaging). Nearly 90% of patients with misdiagnosed CAP received full courses of antibiotics (>3 days). Inappropriate diagnosis of CAP was more likely in older patients (particularly those older than 75) and those with dementia or altered mental status.
Amo…