Pulmonary Infections in Adults: Community-Acquired Pneumonia.

Q3 Medicine
FP essentials Pub Date : 2025-03-01
Thomas M File, Julio A Ramirez
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引用次数: 0

Abstract

Community-acquired pneumonia (CAP) is a common and potentially serious illness, particularly in older patients and those with significant comorbidities. Recent evidence indicates diverse communities of microbes reside within the alveoli as part of the lung microbiome and may play a role in the development of pneumonia. A CAP diagnosis is based on the demonstration of a new infiltrate on imaging in a patient with symptoms and signs of pneumonia. Although vaccination has decreased its incidence, Streptococcus pneumoniae (pneumococcus) remains the most common bacterial cause of CAP. Macrolide resistance to S pneumoniae has increased in the United States. With their increasing availability, newer molecular testing methods (eg, respiratory pathogen polymerase chain reaction panel) play a significant role in the evaluation of respiratory viruses. Antimicrobial therapy for hospitalized patients should be based on the results of diagnostic studies to allow pathogen-directed therapy and optimal antimicrobial stewardship. The recommended duration for antimicrobial therapy is 3 to 5 days if there is good clinical improvement by day 2 or 3. Procalcitonin levels can be useful as an adjunct to clinical judgment for determining the appropriate duration of therapy. Smoking cessation and vaccination should be prioritized because they significantly reduce the incidence and severity of CAP.

成人肺部感染:社区获得性肺炎。
社区获得性肺炎(CAP)是一种常见且可能严重的疾病,特别是在老年患者和有显著合并症的患者中。最近的证据表明,作为肺微生物组的一部分,肺泡内存在不同的微生物群落,并可能在肺炎的发展中发挥作用。CAP诊断是基于有肺炎症状和体征的患者在影像学上显示新的浸润。尽管疫苗接种降低了其发病率,但肺炎链球菌(肺炎球菌)仍然是CAP最常见的细菌原因。在美国,大环内酯类药物对肺炎链球菌的耐药性有所增加。随着新的分子检测方法(如呼吸道病原体聚合酶链反应面板)的日益普及,它们在呼吸道病毒的评估中发挥着重要作用。住院患者的抗菌药物治疗应基于诊断研究的结果,以允许病原体定向治疗和最佳抗菌药物管理。如果在第2天或第3天有良好的临床改善,建议抗菌治疗的持续时间为3至5天。降钙素原水平可作为辅助临床判断,以确定适当的治疗时间。应优先考虑戒烟和接种疫苗,因为它们可显著降低CAP的发病率和严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
FP essentials
FP essentials Medicine-Medicine (all)
CiteScore
1.00
自引率
0.00%
发文量
58
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