Quality statement 5: Antibiotic therapy within 4 hours in hospital

Quality statement

Adults with community‑acquired pneumonia who are admitted to hospital start antibiotic therapy within 4 hours of presentation.

Rationale

Starting appropriate antibiotic therapy as soon as possible (and within 4 hours of presentation) is important for treating adults with community‑acquired pneumonia who are admitted to hospital. Evidence shows that early treatment is associated with improved clinical outcomes.

Quality measures

Structure

Evidence of local arrangements to ensure that adults with community‑acquired pneumonia who are admitted to hospital start antibiotic therapy within 4 hours of presentation.

Data source: Local data collection.

Process

Proportion of hospital admissions of community‑acquired pneumonia in adults at which antibiotic therapy is started within 4 hours of presentation.

Numerator – the number in the denominator at which antibiotic therapy is started within 4 hours of presentation.

Denominator – the number of hospital admissions of community‑acquired pneumonia in adults.

Data source: Local data collection.

Outcome

Mortality.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (secondary care services) ensure that adults who are admitted to hospital and diagnosed with community‑acquired pneumonia start antibiotic therapy within 4 hours of presentation.

Healthcare professionals (hospital clinicians) ensure adults who are admitted to hospital and diagnosed with community‑acquired pneumonia start antibiotic therapy within 4 hours of presentation.

Commissioners (clinical commissioning groups) commission services in which adults who are admitted to hospital and diagnosed with community‑acquired pneumonia start antibiotic therapy within 4 hours of presentation.

What the quality statement means for patients, service users and carers

Adults who are admitted to hospital and diagnosed with community‑acquired pneumonia start antibiotic treatment within 4 hours of being seen.

Source guidance

Pneumonia in adults: diagnosis and management (2014) NICE guideline CG191, recommendations 1.2.8 (key priority for implementation) and 1.2.9

Definition of terms used in this quality statement

Community‑acquired pneumonia

Pneumonia that is acquired outside hospital. Pneumonia that develops in a person living in a nursing or residential home is included in this definition. Pneumonia that develops in people who are immunocompromised, and terminal pneumonia associated with another disease are not included.

[Pneumonia in adults (2014) NICE guideline CG191 and expert opinion]