Waschbisch T, Schlesser M, Nati R
Service de Pneumologie, Centre Hospitalier du Luxembourg, 4, rue Barblé, L-1210 Luxembourg.
Bull Soc Sci Med Grand Duche Luxemb. 2002(2):121-34.
The community-acquired pneumonia is a common and serious illness. Pneumonia is said to be community acquired if it is contracted outside of hospital environment or if it is diagnosed within the first 48 hours of hospitalisation. The pathogen remains unknown after investigations in around 50%. The patient should initially be treated empirically, based on the likely pathogens according to the patient's risk-factors, underlying diseases, severity of pneumonia and place of therapy. If recent guidelines are compared (American Thoracic Society, British Thoracic Society and the Infectious Disease Advisory Board) there are differences concerning epidemiology, patients classification and the empiric antibiotic treatment. The appearance of resistances and the recent availability of new antibiotics account partially for these differences. In order to avoid further resistances but still achieving an efficient treatment, coherent antibiotic schemes considering local microbiological epidemiology and patients classifications must be applied as proposed by different guidelines.
社区获得性肺炎是一种常见且严重的疾病。如果肺炎是在医院环境之外感染的，或者在住院的头48小时内被诊断出来，就被称为社区获得性肺炎。经过调查，约50%的病例病原体仍不明。应根据患者的危险因素、基础疾病、肺炎严重程度和治疗地点，基于可能的病原体对患者进行初始经验性治疗。如果比较近期的指南（美国胸科学会、英国胸科学会和传染病咨询委员会），在流行病学、患者分类和经验性抗生素治疗方面存在差异。耐药性的出现以及新抗生素的近期可得性部分解释了这些差异。为了避免进一步的耐药性，但仍实现有效的治疗，必须按照不同指南的建议，应用考虑当地微生物流行病学和患者分类的连贯抗生素方案。
