Patients and study site
Charts of potential cases were identified retrospectively by International Coding of Diagnosis (Ninth Revision) classification, including codes for pneumonia and potentially overlapping diagnostic codes, including chronic bronchitis, emphysema and asthma — buy flovent inhaler. A stratified, random sample of potential cases, admitted to our institutions between November 1997 and June 2000, was reviewed. Based on resource limitations, our review was limited to 70% of cases admitted during each study era (defined below). Eligible cases required at least one symptom (dyspnea, cough, fever), a consistent radiograph and antibiotic treatment for CAP. Exclusion criteria were infection with human immunodeficiency virus or being otherwise immune suppressed, known or suspected tuberculosis, discharge from an acute care hospital within 10 days before study admission and presence of a concurrent nonrespirato-ry infection requiring antibacterial therapy. The study sites were the Toronto General Hospital, Toronto Western Hospital and Mount Sinai Hospital (tertiary care, teaching hospitals affiliated with the University of Toronto, Toronto, Ontario).