community acquired pneumonia

MeSH

Diagnosis and Treatment of Community-Acquired Pneumonia (CAP)

A 23 minutes audiotaped interview on diagnosis and management of community acquired pneumonia. James W. Mold, MD, MPH

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Community-acquired pneumonia is associated with approximately 740 000 hospitalizations and 41 000 deaths in the US annually. JAMA Review authors Scott A. Flanders, MD, and Valerie M. Vaughn, MD, MSc, discuss diagnosis and treatment of community-acquired pneumonia with JAMA Deputy Editor Mary McGrae McDermott, MD.

Author/s:

Scott A. Flanders, Valerie M. Vaughn

Diagnosis and Treatment of Community-Acquired Pneumonia (CAP)

Alex Haga — Wed, 18 Sep 2024 17:07:42 +0000

Date Added:

September 18, 2024

Journal/Publication:

JAMA

Publication Date:

September 16, 2024

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Web Page

Keywords

CAP

MeSH

Community-Acquired Pneumonia: A Review

An audiotaped summary of the current recommendations for diagnosis and management of patients with community acquired pneumonia. James W. Mold, MD, MPH

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Author/s:

Scott A. Flanders, Valerie M. Vaughn, Mary McGrae McDermott

Community-Acquired Pneumonia: A Review

Alex Haga — Wed, 18 Sep 2024 17:02:31 +0000

Date Added:

September 18, 2024

Journal/Publication:

JAMA

Publication Date:

September 16, 2024

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.14796

Keywords

PMID (1):

39283629

MeSH

Respiratory Distress Syndrome

Streptococcus pneumoniae

Ceftriaxone

COVID-19

A review of current thinking regarding the diagnosis and treatment of patients with community acquired pneumonia. James W. Mold, MD, MPH

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Importance: Community-acquired pneumonia (CAP) results in approximately 1.4 million emergency department visits, 740 000 hospitalizations, and 41 000 deaths in the US annually.

Observations: Community-acquired pneumonia can be diagnosed in a patient with 2 or more signs (eg, temperature >38 °C or ≤36 °C; leukocyte count <4000/μL or >10 000/μL) or symptoms (eg, new or increased cough or dyspnea) of pneumonia in conjunction with consistent radiographic findings (eg, air space density) without an alternative explanation. Up to 10% of patients with CAP are hospitalized; of those, up to 1 in 5 require intensive care. Older adults (≥65 years) and those with underlying lung disease, smoking, or immune suppression are at highest risk for CAP and complications of CAP, including sepsis, acute respiratory distress syndrome, and death. Only 38% of patients hospitalized with CAP have a pathogen identified. Of those patients, up to 40% have viruses identified as the likely cause of CAP, with Streptococcus pneumoniae identified in approximately 15% of patients with an identified etiology of the pneumonia. All patients with CAP should be tested for COVID-19 and influenza when these viruses are common in the community because their diagnosis may affect treatment (eg, antiviral therapy) and infection prevention strategies. If test results for influenza and COVID-19 are negative or when the pathogens are not likely etiologies, patients can be treated empirically to cover the most likely bacterial pathogens. When selecting empirical antibacterial therapy, clinicians should consider disease severity and evaluate the likelihood of a bacterial infection-or resistant infection-and risk of harm from overuse of antibacterial drugs. Hospitalized patients without risk factors for resistant bacteria can be treated with β-lactam/macrolide combination therapy, such as ceftriaxone combined with azithromycin, for a minimum of 3 days. Systemic corticosteroid administration within 24 hours of development of severe CAP may reduce 28-day mortality.

Conclusions: Community-acquired pneumonia is common and may result in sepsis, acute respiratory distress syndrome, or death. First-line therapy varies by disease severity and etiology. Hospitalized patients with suspected bacterial CAP and without risk factors for resistant bacteria can be treated with β-lactam/macrolide combination therapy, such as ceftriaxone combined with azithromycin, for a minimum of 3 days.

Author/s:

Valerie M Vaughn, Robert P Dickson, Jennifer K Horowit, Scott A Flanders

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

John Bayhi — Fri, 01 Nov 2019 17:04:48 +0000

Date Added:

November 1, 2019

Journal/Publication:

American Journal of Respiratory and Critical Care Medicine

Publication Date:

October 1, 2019

Issue:

Volume:

200

Pages:

e45-e67

URL:

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1164/rccm.201908-1581ST

Keywords

community-acquired pneumonia

patient management

PMID (1):

31573350

MeSH

Adult

Humans

Interdisciplinary Studies

BTS Guidelines for the Management of Community Acquired Pneumonia in Adults: CURB-65

research

anti-bacterial agents

An updated guideline for management of community-acquired pneumonia. James W. Mold, MD, MPH

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Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia.

Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.

Results: The panel addressed 16 specific areas for recommendations spanning questions of diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions.

Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.

Author/s:

Metlay, JP, Waterer, GW, Long, AC, Anzueto, A, Brozek, J, Crothers, K, Cooley, LA, Dean, NC, Fine, MJ, Flanders, SA, Griffin, MR, Metersky, ML, Musher, DM, Restrepo, MI, Whitney, CG

BTS Guidelines for the Management of Community Acquired Pneumonia in Adults: CURB-65

Jeffrey Wilson — Tue, 28 Aug 2018 19:22:36 +0000

Date Added:

August 28, 2018

Journal/Publication:

Thorax

Publisher:

British Thoracic Society

Publication Date:

September 24, 2009

Issue:

Pages:

iii1-iii55

URL:

Type:

Clinical Decision Aids

Format:

Article

DOI (1):

10.1136/thx.2009.121434

Keywords

decision support

CAP

PMID (1):

19783532

MeSH

https://www.ncbi.nlm.nih.gov/pubmed/19783532

Evidence-Based Clinical decision tools for deciding where to manage patients with community-acquired pneumonia. CURB-65 includes BUN; CRB-65 does not.

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The British Thoracic Society (BTS) Guidelines for the management of Community Acquired Pneumonia (CAP) in Adults was published in December 2001 and superseded Guidelines published in 1993. A web-based update of the 2001 Guidelines was published in 2004. The 2004 Guidelines assessed relevant evidence published up to August 2003.

This update represents a further assessment of published or available evidence from August 2003 to August 2008. An identical search strategy, assessment of relevance and appraisal of articles, and grading system was used.

Author/s:

British Thoracic Society Standards of Care Committee, British Thoracic Society Pneumonia Guidelines Committee

BTS Guidelines for the Management of Community Acquired Pneumonia in Adults: CRB-65

Jeffrey Wilson — Tue, 28 Aug 2018 19:19:14 +0000

Date Added:

August 28, 2018

Journal/Publication:

Thorax

Publisher:

British Thoracic Society

Publication Date:

September 24, 2009

Issue:

Pages:

iii1-iii55

URL:

Type:

Clinical Decision Aids

Format:

Article

DOI (1):

10.1136/thx.2009.121434

Keywords

decision support

CAP

PMID (1):

19783532

MeSH