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June 24, 1998

Quality of Care for Elderly Patients With Pneumonia

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(24):1950-1952. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-24-jac80011

To the Editor.— In the article by Dr Meehan and colleagues,1 the Figure (on page 2083) shows a relationship between the hours within which antibiotics were administered and the adjusted odds of 30-day mortality.

I am unable to reconcile the Figure with the conclusion that administering antibiotics within 8 hours of hospital arrival is associated with improved survival. The shortest interval of 1 hour is associated with the highest mortality, and the time frame after 8 hours is associated with the lowest odds ratio. Unless I am misinterpreting the figure, the conclusion of the article is erroneous, even though plausible.

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