About 12% of patients were inappropriately diagnosed with community-acquired pneumonia (CAP), according to from more than 17鈥�000 hospitalized patients across 48 hospitals in Michigan. Older people as well as those with dementia or altered mental status were at particularly high risk of being inappropriately diagnosed, which the researchers defined as patients receiving antibiotics when they had fewer than 2 symptoms of pneumonia or negative chest x-ray results.
Because older people are at higher risk of worse outcomes following a pneumonia diagnosis, clinicians sometimes are quick to prescribe antibiotics when they suspect the disease. Guidelines recommend that they reassess 2 or 3 days later. Yet about 88% of patients overdiagnosed with CAP received an antibiotic course that lasted longer than 3 days, the researchers reported in JAMA Internal Medicine. That percentage suggests that clinical teams didn鈥檛 tend to stop administering antibiotics once they started them, they noted.
Misdiagnosing CAP could harm patients by obscuring their true conditions and exposing them to adverse effects of unnecessary antibiotics. And wrongly diagnosed patients who received the full course of antibiotics had more drug鈥揳ssociated adverse events, the researchers discovered. Because of that, 鈥渂alancing harms of underdiagnosis and overdiagnosis of CAP remains essential,鈥� the researchers wrote.
Published Online: April 19, 2024. doi:10.1001/jama.2024.5920