An appraisal of treatment guidelines for antepartum community-acquired pneumonia

Nicole P. Yost, Steven L. Bloom, Sherrie D. Richey, Susan M. Ramin, F. Gary Cunningham

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

OBJECTIVE: The optimal strategy for the initial evaluation and management, including criteria for hospitalization, of pregnant women with pneumonia has not been defined. Our purpose was to evaluate a treatment protocol for antepartum pneumonia and to identify criteria for selection of women for potential outpatient treatment. STUDY DESIGN: A protocol based on British and American Thoracic Society guidelines was introduced and included prompt hospitalization and empiric initiation of erythromycin therapy. Maternal and neonatal outcomes were analyzed to assess the efficacy of the protocol. A second analysis involved the retrospective application of published guidelines to ascertain for which women outpatient management might have been appropriate. RESULTS: There were no maternal deaths among the 133 women studied, and in 14 (10%) women there was a misdiagnosis at admission. Erythromycin monotherapy was judged adequate in all but one of the 99 women so treated. Using a modified version of the American Thoracic Society guidelines, we project that only 25% of the women hospitalized with pneumonia could have been managed safely as outpatients. CONCLUSION: Most pregnant women with pneumonia respond well to monotherapy with erythromycin. Outpatient management may be a reasonable option for selected women.

Original languageEnglish (US)
Pages (from-to)131-135
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Volume183
Issue number1
DOIs
StatePublished - Jan 1 2000

Keywords

  • Erythromycin
  • Outpatient management
  • Pneumonia
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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