Abstract
Background: Community-acquired bronchopneumonia remains a major cause of morbidity and hospitalization worldwide, with outcomes influenced by severity assessment, guideline adherence, and timely antibiotic therapy. Variability in practice across healthcare levels, particularly between local and tertiary hospitals, contributes to differences in clinical outcomes.
Objective: To compare the management of adult patients with bronchopneumonia between local and tertiary hospitals, evaluate adherence to established treatment guidelines, identify factors associated with clinical cure, and assess antibiotic-related adverse effects.
Methods: A cross-sectional observational study was conducted among adults diagnosed with bronchopneumonia. CURB-65 scores, comorbidities, and clinical characteristics were recorded. Empirical antibiotic selection, adherence to recommended guidelines, timing of antibiotic initiation, and duration of therapy were evaluated. Outcomes assessed included clinical cure, treatment failure, ICU admission, mortality, and documented adverse drug reactions. Descriptive statistics, chi-square tests, and correlation analyses were used to compare groups, while regression analysis identified predictors of clinical cure.
Results: Most participants were treated at tertiary hospitals, which demonstrated higher adherence to guideline-recommended antibiotics and more consistent use of CURB-65 scoring. Early antibiotic initiation (within 4 hours) was significantly associated with clinical cure. Aminopenicillins were the most frequently used agents, while broad-spectrum antibiotics were more common in patients with higher CURB-65 scores. Adverse effects were generally mild, with gastrointestinal symptoms predominating. Guideline adherence, lower severity scores, and absence of comorbidities were significant predictors of clinical cure.
Conclusion: Effective management of community-acquired bronchopneumonia depends on accurate severity assessment, timely antibiotic therapy, and adherence to treatment guidelines. Tertiary hospitals demonstrated better compliance with recommended practices, resulting in improved clinical outcomes. Strengthening antibiotic stewardship and standardizing pneumonia management pathways—especially in local hospitals—may enhance patient outcomes and reduce treatment failure.