LAUSR

Aims Our aim was to collect data on children admitted to Midlands Regional Hospital, Portlaoise (MRHP) with a diagnosis of Community Acquired Pneumonia (CAP). We looked into presenting complaints, clinical signs, investigation, management and follow-up plan made on these patients. In winter 2016/17 this data was compared with data from 16 other hospitals across the UK and Ireland as part of the British Thoracic Society’s (BTS) audit on CAP. Now, in winter 2018/19, we did re-audit to look at progress of our own department in 2 years. Methods A retrospective chart review was carried out to identify patients with CAP. Inclusion criteria included children presenting to MRHP aged 1–15 years with a diagnosis of CAP over Oct – Dec 2018. Results There was a massive improvement regarding choice of antibiotics to treat CAP and we switched to amoxicillin in majority of cases, which is in line with recommendation of BTS, UK. Our data is comparable to international data and previous local data with regard to demographics and severity of pneumonia requiring O2 therapy. We still are performing more blood tests (including acute phase reactants and microbiological investigations) and chest x-rays than other centers but there is decrease in these numbers as compared to our own previous data. Conclusions The over diagnosis, over investigation and over treatment of CAP is leading to wasted resources and is not in adherence with best practice. After the recommendations from our first audit, there was big improvement in few domains and we are progressing towards best practice in others. We are also in the process of completion of our local guidelines and after their introduction; we expect our efficacy to improve even more. References BTS UK community acquired pneumonia in children guidelines: https://www.brit-thoracic.org.uk/document-library/audit-and-quality-improvement/audit-reports/bts-paediatric-community-acquired-pneumonia-audit-report-201617/https://www.brit-thoracic.org.uk/document-library/clinical-information/pneumonia/paediatric-pneumonia/bts-guidelines-for-the-management-of-community-acquired-pneumonia-in-children-update-2011/