Baseline Characteristics and Treatments of Dutch and US Nursing Home Residents Who Received Antibiotics for Lower Respiratory Tract Infection (Percentage Unless Otherwise Noted)
| Characteristics and Treatments Received | United States (n = 806) | Netherlands (n = 415) | P* |
|---|---|---|---|
| * US-Dutch comparison, χ2 probability for discrete variables, t test probability for continuous variables. | |||
| † A score of 0 represents independence, 1, some to moderate dependence, and 2, complete dependence. | |||
| ‡ Because of small numbers, these categories were combined for analysis of Dutch residents. | |||
| § Four US residents received antibiotics, both intramuscularly and intravenously, making the sum of the percentages exceed 100%. | |||
| Resident characteristics | |||
| Demographics | |||
| Age, year, mean (SD) | 86.1 (7.1) | 84.5 (6.2) | <.001 |
| Female | 67.6 | 66.0 | .57 |
| Complete dependence at the time of diagnosis† | |||
| Dressing | 46.5 | 82.1 | <.001 |
| Eating | 28.0 | 55.1 | <.001 |
| Mobility | 60.9 | 60.1 | .78 |
| Illness signs and symptoms | |||
| Cough | 83.8 | 76.1 | .001 |
| Decreased alertness | 27.6 | 42.0 | <.001 |
| New or increased confusion | 9.6 | 8.6 | .61 |
| Physical findings on lung examination compatible with pneumonia or other lower respiratory tract infection | 81.3 | 97.3 | <.001 |
| Pulse, beats per minute, mean (SD) | 87.6 (17.2) | 92.5 (16.9) | <.001 |
| Purulent sputum | 25.6 | 32.7 | .012 |
| Respiratory difficulty | 23.4 | 55.9 | <.001 |
| Respiratory rate, breaths per minute, mean (SD) | 26.8 (7.0) | 26.7 (8.9) | .78 |
| Temperature, °C, mean (SD) | 37.6 (0.9) | 38.5 (0.9) | <.001 |
| Comorbidities and conditions | |||
| Congestive heart failure | 32.6 | 17.9 | <.001 |
| Chronic obstructive pulmonary disease | 20.2 | 15.7 | .057 |
| Decubitus ulcers | 8.8 | 13.0 | .02 |
| Dehydration present | 20.9 | 34.7 | <.001 |
| Diabetes mellitus | 19.4 | 16.2 | .18 |
| Parkinson disease | 9.9 | 7.5 | .16 |
| Severe dementia | 25.2 | 51.1 | <.001 |
| Beds in facility, N, mean (SD) | 152.0 (115.2) | 219.1 (58.2) | <.001 |
| Treatments received | |||
| Antibiotic | <.001 | ||
| Oral amoxicillin | 11.3 | 51.1 | |
| Oral amoxicillin/clavulanate | 4.0 | 20.7 | |
| Oral doxycycline, tetracycline, macrolide, or trimethoprim-sulfamethoxazole | 27.8 | 13.5 | |
| Intramuscular ampicillin or amoxicillin, followed by oral amoxicillin | 0.0 | 11.1 | |
| Fluoroquinolone, with or without another agent‡ | 13.3 | 1.4 | |
| First-generation or oral second-generation cephalosporin‡ | 11.3 | 0.5 | |
| Parenteral second-generation or third-generation cephalosporin‡ | 18.2 | 1.2 | |
| Other antibiotic regimens‡ | 14.1 | 0.5 | |
| Route of antibiotic administration | |||
| Oral only | 67.9 | 87.2 | <.001 |
| Intramuscular§ | 12.4 | 11.8 | .76 |
| Intravenous§ | 20.2 | 1.0 | <.001 |
| Hospitalization | 30.4 | 0.2 | <.001 |
| Rehydration therapy | 34.5 | 3.0 | <.001 |