Background Community Acquired Pneumonia (CAP) is the most common reason for antibiotic treatment in hospitalized adults. Some prior studies have found treatment differences by race/ethnicity, but research on the topic is limited, results are mixed, and it is unclear if clinical outcomes are affected. Methods We conducted a retrospective analysis of hospitalized patients >=18 years of age with a diagnosis of CAP from 2018–2021 across 457 US hospitals in the Vizient Inc. Clinical Data Base. We examined guideline concordant antibiotic treatment differences for inpatient CAP by patient race/ethnicity and hospital level factors and secondarily assessed whether treatment differences affect patient clinical outcomes. Results There were 1,277,770 admissions. Over half of all patients received concordant antibiotic therapy. Non-Hispanic Black patients had an increased odds of receiving guideline concordant antibiotic care (OR 1.22 95% CI 1.21–1.23) compared to non-Hispanic White patients. As the number of hospital beds increased, the odds of receiving concordant therapy decreased, with the greatest reduced odds between hospitals with >500 beds vs 2 (OR 0.71 95% CI 0.7–0.72). Patients at hospitals in the South (OR 0.8 95% CI 0.79–0.81) and Northeast (OR 0.71, 95% CI 0.7–0.72) were less likely than those in the West to receive concordant care. There was no significant association between the interaction of race/ethnicity and receipt of guideline concordant therapy and clinical outcomes. Conclusion Non-Hispanic Black patients were more likely to received guideline-concordant care for CAP however significant differences in concordant therapy were seen at the hospital level. Understanding the interplay of race/ethnicity and concordant CAP therapy at the individual and population level is important for future research in the examination of disparities in care.
Burrowes et al. (Wed,) studied this question.