Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review

被引：10

作者：

Candel, Francisco Javier ^{[1
,2
]}

Salavert, Miguel ^{[3
]}

Basaras, Miren ^{[4
]}

Borges, Marcio ^{[5
,6
]}

Canton, Rafael ^{[7
,8
]}

Cercenado, Emilia ^{[9
]}

Cilloniz, Catian ^{[10
,11
]}

Estella, Angel ^{[12
]}

Garcia-Lechuz, Juan M. ^{[13
]}

Garnacho Montero, Jose ^{[14
]}

Gordo, Federico ^{[15
]}

Julian-Jimenez, Agustin ^{[16
]}

Martin-Sanchez, Francisco Javier ^{[17
]}

Maseda, Emilio ^{[18
]}

Matesanz, Mayra ^{[19
]}

Menendez, Rosario ^{[20
]}

Miron-Rubio, Manuel ^{[21
]}

de Lejarazu, Raul Ortiz ^{[22
]}

Polverino, Eva ^{[23
,24
,25
]}

Retamar-Gentil, Pilar ^{[8
,26
]}

Ruiz-Iturriaga, Luis Alberto ^{[27
,28
]}

Sancho, Susana ^{[29
]}

Serrano, Leyre ^{[27
,28
]}

机构：

[1] Hosp Clin Univ San Carlos, Clin Microbiol & Infect Dis, Transplant Coordinat IdISSC, Madrid 28040, Spain

[2] Hosp Clin Univ San Carlos, IML Hlth Res Inst, Madrid 28040, Spain

[3] Univ Hosp La Fe, La Fe IIS Hlth Res Inst, Infect Dis Unit, Valencia 46015, Spain

[4] Univ Basque Country, Fac Med & Nursing, Immunol Microbiol & Parasitol Dept, Bizkaia 48940, Spain

[5] Univ Hosp Son Llatzer, Intens Med Dept, Multidisciplinary Sepsis Unit, Palma De Mallorca 07198, Spain

[6] Inst Invest Sanitaria Illes Balears IdISBa, Islas Baleares 07198, Spain

[7] Univ Hosp Ramon & Cajal, Inst Ramon & Cajal Hlth Res IRYCIS, Clin Microbiol Serv, Madrid 28034, Spain

[8] Natl Inst Hlth San Carlos III, CIBER Infect Dis CIBERINFEC, Madrid 28034, Spain

[9] Univ Hosp Gregorio Maranon, Clin Microbiol & Infect Dis Serv, Madrid 28009, Spain

[10] IDIBAPS, CIBERES, Barcelona 08007, Spain

[11] Continental Univ, Fac Hlth Sci, Huancayo 15304, Peru

[12] Univ Cadiz, Univ Hosp Jerez, Intens Care Unit, Med Dept,INIBiCA, Cadiz 11404, Spain

[13] Univ Hosp Miguel Servet, Clin Microbiol, Zaragoza 50009, Spain

[14] Hosp Univ Virgen Macarena, Intens Care Clin Unit, Seville 41013, Spain

[15] Univ Hosp Henares, Intens Med Dept, Madrid 28802, Spain

[16] Univ Hosp Toledo, Univ Castilla Mancha, Emergency Dept, Toledo 45007, Spain

[17] Clin Univ Hosp San Carlos, Emergency Dept, Madrid 28040, Spain

[18] Hosp Quiron Salud Valle Henares, Anesthesiol Dept, Madrid 28850, Spain

[19] Clin Univ Hosp San Carlos, Hosp Home Unit, Madrid 28040, Spain

[20] Univ Hosp La Fe, Fe IIS Hlth Res Inst, Pneumol Serv, Valencia 46015, Spain

[21] Univ Torrejon, Hosp Home Serv, Torrejon De Ardoz 28006, Madrid, Spain

[22] Univ Valladolid, Clin Univ Hosp Valladolid, Natl Influenza Ctr, Valladolid 47003, Spain

[23] Hosp Valle De Hebron, Pneumol Serv, Barcelona 08035, Spain

[24] Vall dHebron Barcelona Hosp Campus, Vall dHebron Inst Recerca VHIR, Barcelona 08035, Spain

[25] Inst Hlth Salud Carlos III, CIBER Resp Dis CIBERES, Madrid 28029, Spain

[26] Univ Seville, Univ Hosp Virgen Macarena, Infect Dis & Microbiol Clin Management Unit, IBIS, Seville 41013, Spain

[27] Univ Hosp Cruces, Pneumol Serv, Baracaldo 48903, Spain

[28] Univ Basque Country, Fac Med & Nursing, Bizkaia 48940, Spain

[29] Univ Hosp La Fe, Intens Med Dept, Valencia 46015, Spain

来源：

JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 21期

关键词：

community acquired pneumonia; aetiology; radiologic findings; management; readmission; hospital at home; therapeutic failure; vaccination; INFECTIOUS-DISEASES-SOCIETY; PARENTERAL ANTIBIOTIC-THERAPY; RESPIRATORY-DISTRESS-SYNDROME; IDSA/ATS MINOR CRITERIA; INTENSIVE-CARE UNITS; LOW-RISK PATIENTS; 30-DAY READMISSIONS; RESISTANT PATHOGENS; HOSPITAL DISCHARGE; TREATMENT FAILURE;

D O I：

10.3390/jcm12216864

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Community-acquired pneumonia represents the third-highest cause of mortality in industrialized countries and the first due to infection. Although guidelines for the approach to this infection model are widely implemented in international health schemes, information continually emerges that generates controversy or requires updating its management. This paper reviews the most important issues in the approach to this process, such as an aetiologic update using new molecular platforms or imaging techniques, including the diagnostic stewardship in different clinical settings. It also reviews both the Intensive Care Unit admission criteria and those of clinical stability to discharge. An update in antibiotic, in oxygen, or steroidal therapy is presented. It also analyzes the management out-of-hospital in CAP requiring hospitalization, the main factors for readmission, and an approach to therapeutic failure or rescue. Finally, the main strategies for prevention and vaccination in both immunocompetent and immunocompromised hosts are reviewed.

引用

页数：34

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