TY - JOUR
T1 - Advances in the causes and management of community acquired pneumonia in adults
AU - Wunderink, Richard G.
AU - Waterer, Grant
PY - 2017/7/10
Y1 - 2017/7/10
N2 - Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia. Optimal treatment remains a matter for debate, especially in very sick patients, including the role of combination antibiotic therapy and corticosteroids. Pneumonia care bundles are being defined to improve outcomes. Increased recognition of both acute and long term cardiac complications is shifting our concept of pneumonia from an acute lung disease to a multisystem problem with adverse chronic health consequences.
AB - Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia. Optimal treatment remains a matter for debate, especially in very sick patients, including the role of combination antibiotic therapy and corticosteroids. Pneumonia care bundles are being defined to improve outcomes. Increased recognition of both acute and long term cardiac complications is shifting our concept of pneumonia from an acute lung disease to a multisystem problem with adverse chronic health consequences.
KW - CARE-ASSOCIATED PNEUMONIA
KW - RESISTANT STAPHYLOCOCCUS-AUREUS
KW - RANDOMIZED CONTROLLED-TRIALS
KW - INFECTIOUS-DISEASES-SOCIETY
KW - CHEST-X-RAY
KW - RESPIRATORY-TRACT INFECTIONS
KW - CLINICAL-PRACTICE GUIDELINES
KW - PANTON-VALENTINE LEUKOCIDIN
KW - PATIENT DATA METAANALYSIS
KW - ACUTE CORONARY SYNDROMES
UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-85023756015&origin=resultslist&sort=plf-f&src=s&st1=
U2 - 10.1136/bmj.j2471
DO - 10.1136/bmj.j2471
M3 - Review article
C2 - 28694251
VL - 358
JO - BMJ: British Medical Journal
JF - BMJ: British Medical Journal
SN - 0959-535X
M1 - J2471
ER -