Angrill N, Gallego M, Font J, et al. - Researchers conducted an observational, retrospective, 1-year cohort study in hospitalized adults with pneumonia to determine the prevalence of antipseudomonal antibiotic prescriptions and to ascertain the determinants of empirical antibiotic choices in the emergency department. Assessment of data from 549 adults with pneumonia was done. Pseudomonas aeruginosa were isolated from only nine (1.6%) patients. Compliance with SEPAR guidelines was observed in most (85%) prescriptions; 207 (37%) patients were provided antibiotics with antipseudomonal activity [14% β-lactam antipseudomonals (β-APS) and 23% levofloxacin]. Observations thereby suggest that the patients commonly receive antipseudomonal prescriptions, in spite of the very low incidence of Pseudomonas aeruginosa. Both severity-of-illness and pneumococcal urine antigen test (levofloxacin) and prior hospitalization and ICU admission (β-APS) influenced the rationale for prescription. However, there was no association of these factors with P aeruginosa episodes. They identified only prior P aeruginosa infection/colonization and severe chronic obstructive pulmonary disease as possibly reliable indicators in clinical practice.