Pneumonia treatment

Pneumonia Treatment

Community acquired pneumonia refers to pneumonia acquired outside of hospitals or extended care facilities. Nosocomial pneumonia and hospital acquired pneumonia describe infections acquired in the hospital setting. The symptoms and signs of acute pneumonia develop over hours to days, whereas the clinical presentation of chronic pneumonia frequently evolves over weeks to months. The causative agent of community acquired pneumonia remains unidentified in thirty% to 50% of cases. Inhalation of infectious particles is one of the most crucial pathogenetic mechanism in the development of community acquired pneumonia, with special importance of pneumonia caused by Legionella species and M. Tuberculosis. Direct inoculation rarely occurs as a consequence of surgery or bronchoscopy, but might play a part in the development of pneumonia in patients supported with mechanical ventilation.

Since the clinical syndromes characterizing pneumonic infections caused by various agents frequently overlap one another and since interobserver variability regarding physical results of pneumonia is high, the diagnosis of pneumonia can be challenging. Influenzae Adapted from Mandell LA, Bartlett JG, Dowell SF, et al: Update of practice guidelines for the management of community acquired pneumonia in immunocompetent adults. The composition of the diagnostic workup for pneumonia has been the subject of some disagreement among experts, but a well chosen evaluation can support a diagnosis of pneumonia and identify a pathogen. A study by the Patient Outcome Research Team

investigators has validated a risk scale, now called the pneumonia severity index, for mortality in community acquired pneumonia.

Since these procedures may carry considerable morbidity, they're usually reserved for the deteriorating patient with a pneumonia that defies diagnosis by less invasive techniques.

Powerful molecular techniques are now being applied to the early diagnosis of pneumonia.

Given the large proportion of pneumonia cases for which no microbial cause is identified, it's likely that molecular tools will ultimately be applied to the identification and antimicrobial susceptibility testing of virtually all causative agents of pneumonia. The pneumonia severity index uses history, examination, chest radiograph, and initial laboratory test results to identify low risk patients for outpatient treatment. Antibiotic therapy for community acquired pneumonia should always be selected with patient characteristics, place of acquisition, and severity of disease in mind. Organisms with intrinsic or acquired resistance to drugs commonly utilized in pneumonia therapy should also be considered. A secondary infection, like postinfluenza staphylococcal pneumonia, might prove resistant to initial therapy. Criteria for hospital discharge in community acquired pneumonia are based on common sense.

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