Worldwide perspective of the quality of care provided to hospitalized patients with community-acquired pneumonia: results from the CAPO international cohort study.

National organizations from multiple countries have developed evidence-based recommendations for the management of hospitalized patients with community-acquired pneumonia (CAP). Good quality of care in CAP can be defined as patient care provided in compliance with evidence-based recommendations. To evaluate the quality of care provided to hospitalized patients with CAP, an international network of investigators is collecting local data on quality indicators from 36 hospitals in 14 countries. Participating countries in four regions are performing worldwide benchmarking: North America (region I), Europe (region II), Latin America (region III), and Asia and Africa (region IV). The quality of care provided to 2750 hospitalized patients with CAP was evaluated in the following areas: diagnosis, hospitalization, respiratory isolation, microbiological workup, empirical therapy, switch therapy, hospital discharge, and prevention. The greatest opportunities for improvement were identified in the areas of prevention of CAP, initial empirical therapy, and switch from intravenous to oral antibiotics. This study indicates that the care recommended by national guidelines is not being appropriately delivered to adults in all regions of the world. New interventions to advance quality of care are necessary to improve clinical and economic outcomes in CAP.