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community acquired pneumonia guidelines

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https://www.readbyqxmd.com/read/28012492/guidelines-concordant-empiric-antimicrobial-therapy-and-mortality-in-patients-with-severe-community-acquired-pneumonia-requiring-mechanical-ventilation
#1
Yukiyo Sakamoto, Yasuhiro Yamauchi, Hideo Yasunaga, Hideyuki Takeshima, Wakae Hasegawa, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Takahide Nagase
BACKGROUND: Community-acquired pneumonia (CAP) has high morbidity and mortality among adults. Several clinical guidelines recommend prompt administration of combined antimicrobial therapy. However, the association between guidelines concordance and mortality in patients with severe pneumonia remains unclear. The present study aimed to examine the impact of guidelines-concordant empiric antimicrobial therapy on 7-day mortality in patients with extremely severe pneumonia who required mechanical ventilation at admission, using a nationwide inpatient database in Japan...
January 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28002979/antibiotic-stewardship-in-community-acquired-pneumonia
#2
Diego Viasus, Milly Vecino-Moreno, Juan M De La Hoz, Jordi Carratalà
Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Areas covered: Several elements can be applied to antibiotic stewardship strategies for CAP in order to maintain or improve patient outcomes...
December 27, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27960206/role-of-atypical-pathogens-in-the-etiology-of-community-acquired-pneumonia
#3
Forest W Arnold, James T Summersgill, Julio A Ramirez
Atypical pneumonia has been described for over 100 years, but some of the pathogens attributed to it have been identified only in the past decades. The most common pathogens are Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila. The epidemiology and pathophysiology of these three pathogens have been studied since their discovery, and are reviewed herein to provide better insight when evaluating these patients, which hopefully translates into improved care. The incidence of atypical pathogens has been shown to be approximately 22% worldwide, but this probably varies with location...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27960204/community-acquired-pneumonia-a-global-perspective
#4
Grant W Waterer
Community-acquired pneumonia (CAP) is a global disease responsible for a large proportion of deaths and having significant economic cost. As diagnostic tools have increased in sensitivity, our understanding of the etiology of CAP has begun to change with a significant increase in confirmed viral infections and the recognition that multiple pathogens are frequently present. Empiric therapy remains the standard of care and guidelines are mostly based on published data from the United States or Europe. Blindly applying guidelines without any consideration of local etiological differences can lead to a risk of under or overtreatment...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27956727/assessment-of-cytokine-and-chemokine-signatures-as-potential-biomarkers-of-childhood-community-acquired-pneumonia-severity-a-nested-cohort-study-in-india
#5
Shanie Saghafian-Hedengren, Joseph L Mathew, Eva Hagel, Sunit Singhi, Pallab Ray, Sofia Ygberg, Anna Nilsson
BACKGROUND: Pediatric community-acquired pneumonia (CAP) is a leading cause of childhood mortality in developing countries. In resource-poor settings, pneumonia diagnosis is commonly made clinically, based on World Health Organization guidelines, where breathing difficulty or cough and age-adjusted tachypnea suffice to establish diagnosis. Also, the severity of CAP is generally based on clinical features and existing biomarkers do not reliably correlate to either clinical severity or outcome...
January 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27924871/prognostic-implications-of-aspiration-pneumonia-in-patients-with-community-acquired-pneumonia-a-systematic-review-with-meta-analysis
#6
Kosaku Komiya, Bruce K Rubin, Jun-Ichi Kadota, Hiroshi Mukae, Tomohiro Akaba, Hiroshi Moro, Nobumasa Aoki, Hiroki Tsukada, Shingo Noguchi, Nobuaki Shime, Osamu Takahashi, Shigeru Kohno
: Aspiration pneumonia is thought to be associated with a poor outcome in patients with community acquired pneumonia (CAP). However, there has been no systematic review regarding the impact of aspiration pneumonia on the outcomes in patients with CAP. This review was conducted using the MOOSE guidelines: Patients: patients defined CAP. EXPOSURE: aspiration pneumonia defined as pneumonia in patients who have aspiration risk. Comparison: confirmed pneumonia in patients who were not considered to be at high risk for oral aspiration...
December 7, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27873512/antimicrobial-resistance-and-clinical-outcomes-in-nursing-home-acquired-pneumonia-compared-to-community-acquired-pneumonia
#7
Yun Seong Kang, Soo Ryeong Ryoo, Seung Joo Byun, Yun Jeong Jeong, Jin Young Oh, Young Soon Yoon
PURPOSE: Patients with nursing home-acquired pneumonia (NHAP) should be treated as hospital-acquired pneumonia (HAP) according to guidelines published in 2005. However, controversy still exists on whether the high mortality of NHAP results from multidrug resistant pathogens or underlying disease. We aimed to outline differences and factors contributing to mortality between NHAP and community-acquired pneumonia (CAP) patients. MATERIALS AND METHODS: We retrospectively evaluated patients aged 65 years or older with either CAP or NHAP from 2008 to 2014...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27811579/a-comprehensive-approach-to-pediatric-pneumonia-relationship-between-standardization-antimicrobial-stewardship-clinical-testing-and-cost
#8
Lori Rutman, Davene R Wright, James OʼCallaghan, Suzanne Spencer, K Casey Lion, Matthew P Kronman, Chuan Zhou, Rita Mangione-Smith
OBJECTIVE: In September 2012, our institution implemented an emergency department (ED) and inpatient pathway for community-acquired pneumonia (CAP) based on national guideline recommendations. The objective of this study was to determine the relationship between standardizing ED and inpatient care for CAP and antimicrobial stewardship, clinical testing, and cost. METHODS: We used descriptive statistics, statistical process control, and interrupted time series analysis to analyze measures 12 months before and after implementation...
November 1, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27803507/role-of-atypical-bacteria-in-hospitalized-patients-with-nursing-home-acquired-pneumonia
#9
Laura Meyer-Junco
Background: Nursing home-acquired pneumonia (NHAP) has been identified as one of the leading causes of mortality and hospitalization for long-term care residents. However, current and previous pneumonia guidelines differ on the appropriate management of NHAP in hospitalized patients, specifically in regard to the role of atypical bacteria such as Chlamydiae pneumonia, Mycoplasma pneumoniae, and Legionella. Objectives: The purpose of this review is to evaluate clinical trials conducted in hospitalized patients with NHAP to determine the prevalence of atypical bacteria and thus the role for empiric antibiotic coverage of these pathogens in NHAP...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27766169/microbial-etiology-of-community-acquired-pneumonia-among-infants-and-children-admitted-to-the-pediatric-hospital-ain-shams-university
#10
Magda Yehia El Seify, Eman Mahmoud Fouda, Hanan Mohamed Ibrahim, Maha Muhammad Fathy, Asmaa Al Husseiny Ahmed, Walaa Shawky Khater, Noha Nagi Mohammed Salah El Deen, Heba Galal Mohamed Abouzeid, Nancy Riyad Ahmed Hegazy, Heba Salah Sayed Elbanna
BACKGROUND: While recognizing the etiology of community-acquired pneumonia is necessary for formulating local antimicrobial guidelines, limited data is published about this etiology in Egyptian pediatric patients. OBJECTIVES: To determine the frequency of bacterial and viral pathogens causing community-acquired pneumonia (CAP) among immunocompetent Egyptian infants and preschool children. METHODS: Ninety infants and preschool-age children admitted to our hospital with CAP were prospectively included in the study...
September 29, 2016: European Journal of Microbiology & Immunology
https://www.readbyqxmd.com/read/27759360/a-relook-of-cefuroxime-in-community-infections-an-option-still-beneficial
#11
V R Badhwar, S Ganapathy, P P Prabhudesai, N K Tulara, A Y Varaiya, D Vyas
In community and family practice, infections are a common OPD presentation. In the management of common bacterial infections seen in community especially RTI, UTI, SSTI; cefuroxime a second generation cephalosporin with a broad spectrum of activity can be used for empirical treatment. To know current place of cefuroxime in the management of infections, physicians, surgeons, microbiologist, chest physician, gynecologist and pediatrician came together to discuss and debate their experience with cefuroxime and its place in today's world...
July 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27755118/community-acquired-pneumonia-in-the-post-13-valent-pneumococcal-conjugate-vaccine-era
#12
Erin E Shaughnessy, Erika L Stalets, Samir S Shah
PURPOSE OF REVIEW: This review covers the outpatient management of pediatric community-acquired pneumonia (CAP), discussing the changing microbiology of CAP since the introduction of the 13-valent pneumococcal conjugate vaccine in 2010, and providing an overview of national guideline recommendations for diagnostic evaluation and treatment. RECENT FINDINGS: Rates of invasive pneumococcal disease and pneumococcal antibiotic resistance have plummeted since widespread 13-valent pneumococcal conjugate vaccine immunization...
December 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27747254/effects-of-a-syndrome-specific-antibiotic-stewardship-intervention-for-inpatient-community-acquired-pneumonia
#13
Michelle K Haas, Kristen Dalton, Bryan C Knepper, Sarah A Stella, Lilia Cervantes, Connie S Price, William J Burman, Philip S Mehler, Timothy C Jenkins
Background.  Syndrome-specific interventions are a recommended approach to antibiotic stewardship, but additional data are needed to understand their potential impact. We implemented an intervention to improve the management of inpatient community-acquired pneumonia (CAP) and evaluated its effects on antibiotic and resource utilization. Methods.  A stakeholder group developed and implemented a clinical practice guideline and order set for inpatient, non-intensive care unit CAP recommending a short course (5 days) of a fluoroquinolone-sparing antibiotic regimen in uncomplicated cases...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27739904/clinical-utility-of-testing-for-legionella-pneumonia-in-central-texas
#14
Christopher Henry, Carl Boethel, Laurel A Copeland, Shekhar Ghamande, Alejandro C Arroliga, Heath D White
RATIONALE: Legionella pneumophila is an uncommon cause of community-acquired pneumonia in the south central region of the United States, and regular testing may not be cost effective in areas of low incidence. OBJECTIVES: To evaluate the incidence of Legionella in central Texas and to determine the cost effectiveness of Legionella urinary antigen testing. METHODS: We performed a single-center retrospective cohort study of patients admitted with pneumonia between January 2001 and December 2013...
January 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27737908/point-of-care-crp-testing-in-the-diagnosis-of-pneumonia-in-adults
#15
(no author information available yet)
Respiratory tract infections (RTI) are among the most common acute conditions leading to GP consultations and to antibiotic prescribing in primary care, even though 70% are viral, and many others are minor self-limiting bacterial infections.(1-4) Between 0.5% and 1.1% of adults have community-acquired pneumonia every year in the UK, most of whom are managed in primary care.(4,5) The decision to prescribe antibiotics for an acute RTI in primary care is often based on clinical symptoms, which have low sensitivity and specificity, and high inter-observer variability...
October 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27734780/-is-procalcitonin-measurement-useful-in-managing-respiratory-tract-infections
#16
J M Prins, T van der Poll
Better use of current antibiotics is warranted to curb increasing antimicrobial resistance rates. Procalcitonin guidance can safely reduce antibiotic usage when used to initiate or discontinue antibiotics in adult patients with a respiratory tract infection. However, the claimed reductions in antibiotic usage are mainly achieved in patients with acute bronchitis and exacerbations of COPD, conditions for which guidelines already discourage antibiotic treatment. Sequential procalcitonin measurements can also reduce the treatment duration of community-acquired pneumonia from 10-12 to 5-7 days, which is, however, already the recommended treatment duration for in- and outpatients under the current Dutch guidelines...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27681877/community-acquired-respiratory-virus-infections-in-cancer-patients-guideline-on-diagnosis-and-management-by-the-infectious-diseases-working-party%C3%A2-of-the-german-society-for-haematology-and-medical-oncology
#17
Marie von Lilienfeld-Toal, Annemarie Berger, Maximilian Christopeit, Marcus Hentrich, Claus Peter Heussel, Jana Kalkreuth, Michael Klein, Matthias Kochanek, Olaf Penack, Elke Hauf, Christina Rieger, Gerda Silling, Maria Vehreschild, Thomas Weber, Hans-Heinrich Wolf, Nicola Lehners, Enrico Schalk, Karin Mayer
BACKGROUND: Community acquired viruses (CRVs) may cause severe disease in cancer patients. Thus, efforts should be made to diagnose CRV rapidly and manage CRV infections accordingly. METHODS: A panel of 18 clinicians from the Infectious Diseases Working Party of the German Society for Haematology and Medical Oncology have convened to assess the available literature and provide recommendations on the management of CRV infections including influenza, respiratory syncytial virus, parainfluenza virus, human metapneumovirus and adenovirus...
November 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27641310/-vaccination-against-community-acquired-pneumonia-in-adult-patients-a-position-paper-by-neumoexpertos-en-prevenci%C3%A3-n
#18
E Redondo, I Rivero, D A Vargas, E Mascarós, J L Díaz-Maroto, M Linares, J Valdepérez, A Gil, J Molina, I Jimeno, D Ocaña, F Martinón-Torres
INTRODUCTION: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in adults. The annual incidence of CAP in adults in Spain ranges from 3 to 14 cases per 1,000 inhabitants. Current clinical guidelines primarily focus on the therapeutic approach to CAP rather than its prevention. The aim of this study is to develop and propose a practical guide for CAP prevention through vaccination in Spain according to available vaccines and evidence. METHODS: A literature review and expert opinion...
October 2016: Semergen
https://www.readbyqxmd.com/read/27595461/health-care-associated-pneumonia-in-the-intensive-care-unit-guideline-concordant-antibiotics-and-outcomes
#19
Russell T Attridge, Christopher R Frei, Mary Jo V Pugh, Kenneth A Lawson, Laurajo Ryan, Antonio Anzueto, Mark L Metersky, Marcos I Restrepo, Eric M Mortensen
PURPOSE: Recent data have not demonstrated improved outcomes when guideline-concordant (GC) antibiotics are given to patients with health care-associated pneumonia (HCAP). This study was designed to evaluate the relationship between health outcomes and GC therapy in patients admitted to an intensive care unit (ICU) with HCAP. MATERIALS AND METHODS: We performed a population-based cohort study of patients admitted to greater than 150 hospitals in the US Veterans Health Administration system to compare baseline characteristics, bacterial pathogens, and health outcomes in ICU patients with HCAP receiving GC-HCAP therapy, GC community-acquired pneumonia (GC-CAP) therapy, or non-GC therapy...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27567896/severe-community-acquired-pneumonia-timely-management-measures-in-the-first-24-hours
#20
REVIEW
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
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