Background

Six hospitals instituted a voluntary, system-wide, pathway for community acquired pneumonia (CAP). We proposed this study to determine the impact of pathway antibiotics on patient survival, hospital length of stay (LOS), and total hospital cost.

Methods

Data were collected for adults from six U.S. hospitals with a principal CAP discharge diagnosis code, a chest infiltrate, and medical notes indicative of CAP from 2005-2007. Pathway and non-pathway cohorts were assigned according to antibiotics received within 48 hours of admission. Pathway antibiotics included levofloxacin 750 mg monotherapy or ceftriaxone 1000 mg plus azithromycin 500 mg daily. Multivariable regression models assessed 90-day mortality, hospital LOS, total hospital cost, and total pharmacy cost.

Results

Overall, 792 patients met study criteria. Of these, 505 (64%) received pathway antibiotics and 287 (36%) received non-pathway antibiotics. Adjusted means and p-values were derived from Least Squares regression models that included Pneumonia Severity Index risk class, patient age, heart failure, chronic obstructive pulmonary disease, and admitting hospital as covariates. After adjustment, patients who received pathway antibiotics experienced lower adjusted 90-day mortality (p = 0.02), shorter mean hospital LOS (3.9 vs. 5.0 days, p < 0.01), lower mean hospital costs ($2,485 vs. $3,281, p = 0.02), and similar mean pharmacy costs ($356 vs. $442, p = 0.11).

Conclusions

Pathway antibiotics were associated with improved patient survival, hospital LOS, and total hospital cost for patients admitted to the hospital with CAP.

Objectives

To examine factors that influenced doctor of pharmacy (PharmD) students to collaborate with faculty members, preceptors, or others on scholarly activities that resulted in publication of an article in a pharmacy journal, and whether this experience influenced their consideration of a career in academic pharmacy.

Methods

A 17-question survey instrument was e-mailed to student authors of papers published between 2004 and 2008 in 6 pharmacy journals. Responses were analyzed to determine factors influencing student participation in research and whether the experience led them to consider a career in academic pharmacy.

Results

Factors about their participation in the scholarly activity that respondents found valuable included personal fulfillment and making a contribution to the literature. Respondents indicated they were more interested in a career in academic pharmacy after their participation in the scholarly experience (p < 0.001).

Conclusions

Participation in scholarly activities and student authorship of a peer-reviewed journal manuscript during pharmacy school may lead to increased interest in a career in academic pharmacy.