[Diagnostic methods and treatment of community-acquired pneumonia in Spain: NACE study]

Med Clin (Barc). 2002 Sep 21;119(9):321-6. doi: 10.1016/s0025-7753(02)73405-2.
[Article in Spanish]


Background: Community-acquired pneumonia (CAP) is one of the most frequent infectious disease conditions. With the aim of knowing the diagnostic and therapeutic strategies of CAP in Spanish hospitals we performed a prospective, observational and multicenter study.

Patients and method: Observational study of 468 patients with CAP consecutively evaluated in 21 Spanish hospitals. Clinical, diagnostic, therapeutic and evolutive variables were recorded.

Results: We included 468 patients with a mean age of 63 (18) years; 75% of them had some comorbidity. 380 (81%) patients required hospitalization in a conventional ward while 19 (4%) were admitted in an Intensive Care Unit (ICU). 69 patients (15%) required ICU admission. During the first 24 h of admission, biochemical determinations were performed in 98% of cases, blood gas measurements in 88%, blood cultures in 265 (58%), sputum cultures in 149 (41%) and an invasive diagnostic technique was carried out in 17 cases. In 62 cases (14%), a microbiological diagnosis was achieved. Streptococcus pneumoniae (28 cases) was the most frequent isolate followed by Legionella pneumophila (6 cases). Clarithromycin was the most frequent antibiotic prescribed (38%), either as monotherapy (28) or in combination (148), followed by amoxicillin-clavulanate (124 cases). Nine percent of patients were considered non-responders to initial empirical antibiotic tretament. Overall mortality was 6% (25%) and it was significanty higher in non-responders.

Conclusions: In most patients with CAP admitted in Spanish hospitals, a systematic diagnostic approach is lacking. There is an important variability in the administration of antimicrobials, the association of a betalactam plus clarithromycin being the most frequent strategy. Overall mortality is low and significantly higher in those patients with a lack of response to initial antibiotic treatment.

Publication types

  • English Abstract
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonia, Bacterial / complications
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / microbiology
  • Pneumonia, Bacterial / mortality
  • Prospective Studies
  • Spain


  • Anti-Bacterial Agents