Community-acquired pneumonia in adults: Approaches to antibacterial therapy in the context of current clinical guidelines
- Authors: Sinopalnikov AI1
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Affiliations:
- State Institute for Qualification Improvement of Physicians, Ministry of Defense of the Russian Federation, Moscow
- Issue: Vol 82, No 8 (2010)
- Pages: 5-10
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30601
- ID: 30601
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Abstract
Conciliatory guidelines for management of patients with either disease/abnormality have recently become an integral part of medical practice. The popularity of the guidelines is likely to owe to the fact that they are a more or less successful synthesis of abundant information within one document, by giving a physician detailed many-year and many-decade clinical and scientific experience. Since their publication, they become a peculiar standard of medical care delivery. The main benefit of such guidelines should be seen in the diagnosis and treatment standardization (without a physician's losing his/her reasonable autonomy in each individual case) that makes it possible to optimize a diagnostic process, to apply more effective therapeutic approaches, and to use less health care resources.
By taking into account the drastically changing epidemiology of resistance of the causative agents of respiratory tract infection, the emergence of new antibiotics, and the rethinking of conventional diagnostic and therapeutic approaches, there is an apparent need for periodic revision and modification of such guidelines. In this regard, of particular interest are the conciliatory guidelines of the Russian Respiratory Society and Interregional Association of Clinical Microbiology and Antimicrobial Chemotherapy, which were published in 2010.
By taking into account the drastically changing epidemiology of resistance of the causative agents of respiratory tract infection, the emergence of new antibiotics, and the rethinking of conventional diagnostic and therapeutic approaches, there is an apparent need for periodic revision and modification of such guidelines. In this regard, of particular interest are the conciliatory guidelines of the Russian Respiratory Society and Interregional Association of Clinical Microbiology and Antimicrobial Chemotherapy, which were published in 2010.
About the authors
A I Sinopalnikov
State Institute for Qualification Improvement of Physicians, Ministry of Defense of the Russian Federation, Moscow
Email: aisyn@list.ru
State Institute for Qualification Improvement of Physicians, Ministry of Defense of the Russian Federation, Moscow
References
- Чучалин А. Г., Синопальников А. И., Страчунский Л. С. и др. Внебольничная пневмония у взрослых. Практические рекомендации по диагностике, лечению и профилактике. М.: OOO "Изд. дом "М-Вести", 2006.
- Mandell L. A., Niederman M. S. Antimicrobial treatment of community-acquired pneumonia in adults: a conference report. Canadian Community-Acquired Pneumonia Consensus Conference Group. Can. J. Infect. Dis. 1993; 4: 25-51.
- Niederman M. S., Bass J. B., Campbell G. D. et al. Guidelines for the initial empiric therapy of community-acquired pneumonia: proceedings of an American Thoracic Society Consensus Conference. Am. Rev. Resp. Dis. 1993; 148: 1418-1426.
- Charles P. G. P. Development of a severity assessment tool for predicting need for ICU admission in patients with community-acquired pneumonia (CAP). In: 46th ICAAC. San Francisco, 2006.
- Charles P. G. P., Fine M. J., Ramirez J. A. et al. Validation of SMART-COP: a pneumoniae severity assessment tool for predicting with patients will need intensive respiratory or inotropic support (IRIS). In: 47th ICAAC, Chicago; 2007. Abstr. L1156a.
- Mandell L. A., Wunderink R. G., Antonio A. et al. Infectious Diseases Society of America/ American Thoracic Society Consensus Guidelines on the management of community-acquired pneumonia in adults. Clin. Infect. Dis. 2007; 44 (Suppl. 2): S27-S72.
- Lim W. S., Baudouin S. V., George R. C. et al. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax 2009; 64 (Suppl. III): iii1-iii55.
- File T. M. Optimal treatment strategies for community-acquired pneumonia: non-responders to conventional regimens. Chemotherapy 2001; 47 (Suppl. 4): 11-18.
- Fine M. J., Auble T. E., Yealy D. M. et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N. Engl. J. Med. 1997; 336: 243-257.
- Ruiz-Gonz?lez A., Falguera M., Nogués A., Rubio-Caballero M. Is Streptococcus pneumoniae the leading cause of pneumonia of unknown etiology? A microbiologic study of lung aspirates in consecutive patients with community-acquired pneumonia. Am. J. Med. 1999; 106: 385-390.
- Bjerre L. M., Verheij T. J., Kochen M. M. Antibiotics for community acquired pneumonia in adult outpatients. Cochrane Database Syst. Rev. 2009; 4: CD002109.
- Meehan T. P., Fine M. J., Krumholz H. M. et al. Quality of care, process, and outcomes in elderly patients with pneumonia. J. A. M. A. 1997; 278: 2080-2084.
- Houck P. M., Bratzler D. W., Nsa W. et al. Timing of antibiotic administration and outcomes for medicare patients hospitalized with community-acquired pneumonia. Arch. Intern. Med. 2004; 164: 637-644.
- Dunbar L. M., Wunderink R. G., Habib M. P. et al. High-dose, short-course levofloxacin for community- acquired pneumonia: a new treatment paradigm. Clin. Infect. Dis. 2003; 37: 752-760.
- Ramirez J. A., Srinath L., Ahkee S. et al. Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia. Arch. Intern. Med. 1995; 155: 1273-1276.
- Halm E. A., Fine M. J., Marrie T. J. et al. Time to clinical stability in patients hospitalized with community-acquired pneumonia: implications for practice guidelines. J. A. M. A. 1998; 279: 1452-1457.
- Menendez R., Torres A., Rodr?guez de Castro F. et al. Reaching stability in community-acquired pneumonia: the effects of the severity of disease, treatment, and the characteristics of patients. Clin. Infect. Dis. 2004; 39: 1783-1790.
- Niederman M. S., Mandell L. A., Anzueto A. et al. Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am. J. Respir. Crit. Care. Med 2001; 163: 1730-1754.
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