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Community-acquired pneumonia guidelines: a global perspective

tetano

Editor, Senior Moderator
Semin Respir Crit Care Med. 2012 Jun;33(3):298-310. Epub 2012 Jun 20.
Community-acquired pneumonia guidelines: a global perspective.
Niederman MS, Luna CM.
Source

Department of Medicine, Winthrop University Hospital, Mineola, New York.
Abstract

Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality worldwide, and since 1993, guidelines for management have been available. The process, which first began in the United States and Canada, has now been implemented in numerous countries throughout the world, and often each geographic region or country develops locally specific recommendations. It is interesting to realize that guidelines from different regions often interpret the same evidence base differently, and guidelines differ from one country to another, even though the bacteriology of CAP is often more similar than different from one region to another. One of the unique contributions of the 2007 US guidelines is the inclusion of quality and performance measures. In addition, US guidelines emphasize management principles that differ from some of the principles in European guidelines because of unique epidemiological considerations. In addition, certain therapy principles apply in the United States that differ from those in other regions, including the need for all patients to receive routine therapy for atypical pathogens, the emergence of community-acquired methicillin-resistant Staphylococcus aureus in some patients following influenza, and the need for all patients admitted to the intensive care unit to receive at least two antimicrobial agents. In the future, as guidelines evolve, there will be an important place for regional guidelines, particularly if these guidelines can recommend locally specific strategies to implement guidelines, which if successful, can lead to improved patient outcomes.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

PMID:
22718216
[PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/22718216
 
Re: Community-acquired pneumonia guidelines: a global perspective

Technology Implementation Impacting the Outcomes of Patients with CAP

Semin Respir Crit Care Med. 2012 Jun;33(3):292-7. Epub 2012 Jun 20.

Source

Division of Emergency Medicine, University of Utah Medical Center, Salt Lake City, Utah.
Abstract

Community-acquired pneumonia (CAP) combined with influenza is the eighth leading cause of death in the United States. This article examines the literature to understand and describe whether technology implementation has impacted the outcomes of patients with CAP. We conducted an electronic search of PubMed and scanned references of articles meeting inclusion criteria. Twenty-six articles were included in this review. We surveyed this literature for answers to the following questions: Can technology be used to improve quality of care and guideline compliance in CAP? How can we overcome the behavioral bottleneck that prevents adoption of computerized decision support systems? How reliable are our data in the era of electronic medical records? What are the risks associated with technology implementation? No articles demonstrated that technology implementation improves outcomes in the care of patients with CAP.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

PMID:
22718215
[PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/22718215
 
Re: Community-acquired pneumonia guidelines: a global perspective

Semin Respir Crit Care Med. 2012 Jun;33(3):220-31. Epub 2012 Jun 20.
Microbiology and risk factors for community-acquired pneumonia.
Herrero FS, Olivas JB.
Source

Department of Pneumology, Consorci Hospital General, Universitari de Val?ncia, Valencia, Spain.
Abstract

The outcome of community-acquired pneumonia (CAP) depends on the interaction between the infectious agent and the host response. Nowadays the etiology of CAP can be established in ~60% of the cases, and Streptococcus pneumoniae remains the main etiological agent in outpatients, those hospitalized, or those requiring intensive care unit (ICU) admission. Recently, the development of nucleic acid amplification techniques has emphasized the role of viruses as important etiological agents in CAP. However, some demographic factors and comorbidities will determine a higher risk of pneumonia. Thus elderly patients or those with toxic habits (smoking, alcohol abuse), and the presence of various comorbidities (respiratory, metabolic, or renal) favor the development of pneumonia by altering the inflammatory response to infection.Some medications like inhaled corticosteroids could play a role in CAP development in chronic obstructive pulmonary disease (COPD) patients. Fortunately some of these risk factors are preventable and modifiable, for example, through smoking cessation and pneumococcal and influenza vaccinations, which are the biggest successes.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

PMID:
22718208
[PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/22718208
 
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