Guidelines for management of community-acquired pneumonia in adults.

October 30, 2016 at 12:08 pm

Medicina (B Aires). 2015;75(4):245-57.

[Article in Spanish]

Lopardo G1, Basombrío A, Clara L, Desse J, De Vedia L, Di Libero E, Gañete M, López Furst MJ, Mykietiuk A, Nemirovsky C, Osuna C, Pensotti C, Scapellato P.

Author information

1Sociedad Argentina de Infectología, Buenos Aires, Argentina. E-mail: glopardo@intramed.net.

Abstract

Community-acquired pneumonia in adults is a common cause of morbidity and mortality particularly in the elderly and in patients with comorbidities. Most episodes are of bacterial origin, Streptococcus pneumoniae is the most frequently isolated pathogen. Epidemiological surveillance provides information about changes in microorganisms and their susceptibility. In recent years there has been an increase in cases caused by community-acquired meticillin resistant Staphylococcus aureus and Legionella sp. The chest radiograph is essential as a diagnostic tool. CURB-65 score and pulse oximetry allow stratifying patients into those who require outpatient care, general hospital room or admission to intensive care unit. Diagnostic studies and empirical antimicrobial therapy are also based on this stratification. The use of biomarkers such as procalcitonin or C-reactive protein is not part of the initial evaluation because its use has not been shown to modify the initial approach. We recommend treatment with amoxicillin for outpatients under 65 year old and without comorbidities, for patients 65 years or more or with comorbidities amoxicillin-clavulanic/sulbactam, for patients hospitalized in general ward ampicillin-sulbactam with or without the addition of clarithromycin, and for patients admitted to intensive care unit ampicillin-sulbactam plus clarithromycin. Suggested treatment duration is 5 to 7 days for outpatients and 7 to 10 for those who are hospitalized. During the influenza season addition of oseltamivir for hospitalized patients and for those with comorbidities is suggested.

PDF

http://www.medicinabuenosaires.com/PMID/26339883.pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Biología Molecular, CONSENSOS, Epidemiología, GUIDELINES, Infecciones respiratorias, Influenza, Inmunizaciones, Metodos diagnosticos, Resistencia bacteriana, Sepsis, Update. Tags: .

Laboratory Diagnosis of Congenital Toxoplasmosis Insights into Newer Antimicrobial Agents Against Gram-negative Bacteria


Calendar

October 2016
M T W T F S S
« Sep   Nov »
 12
3456789
10111213141516
17181920212223
24252627282930
31  

Most Recent Posts


%d bloggers like this: