Nosocomial pneumonia (NP) is a pulmonary infection acquired during hospitalization and is an important cause of increased morbidity and mortality, prolonged length of stay, and higher healthcare costs. This study aimed to correlate antibiotic therapy (ATB) used before and after NP diagnosis with patient outcomes in a large hospital in Minas Gerais, Brazil. Retrospective cross-sectional study based on chart review of patients ≥18 years hospitalized in 2023 with NP confirmed by the Hospital Infection Control Service. Community-acquired pneumonias, ventilator-associated pneumonias, and pneumonias acquired in other institutions were excluded. Data were reviewed by the responsible infectious disease specialist. The study was approved by the hospital’s technical board and ethics committee, with informed consent waived. Only cases diagnosed after 72 hours of hospitalization were included, according to ANVISA criteria. Anonymized data were organized in spreadsheets and analyzed in SPSS 25.0 using chi-square (χ²) tests and Spearman correlation, with a 5% significance level. Associations between antibiotic regimens administered before and after NP diagnosis and outcomes (discharge, death, or transfer) were evaluated. Before diagnosis, the most common regimen was cephalosporin monotherapy (15.4%), alongside multiple other combinations. A significant association was observed between pre-diagnosis regimens and outcomes (Pearson χ² = 76.07; p = 0.026), suggesting that initial therapy may influence clinical evolution. After diagnosis, penicillin monotherapy (9.2%) and carbapenems combined with glycopeptides (9.2%) predominated, but no significant association with outcomes was found (χ² = 73.46; p = 0.304). The significant correlation between pre-diagnosis antibiotic therapy and outcomes suggests that early antibiotic choice may impact patient evolution. Inappropriate or overly broad antimicrobial use may promote resistance and mortality. In contrast, post-diagnosis antibiotic therapy showed no correlation with clinical evolution (p = 0.304), possibly because it cannot reverse previously established factors. These findings underscore the regional relevance of the study and the importance of rational antimicrobial use in hospitalized patients.
Oliveira et al. (Sun,) studied this question.