Shah Purvin B, Giudice James C, Griesback Russell, Morley Thomas F, Vasoya Amita
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine in Stratford, USA.
J Am Osteopath Assoc. 2004 Dec;104(12):521-6.
Community-acquired pneumonia (CAP) is a leading cause of death in the world and the sixth most common cause of death in the United States. It is the number one cause of death from infectious diseases in the United States. This article reviews the latest available guidelines from two leading organizations-the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS). The IDSA stratifies patients into three categories and recommends antibiotic management based on assigned categories: outpatients, patients admitted to a general medical floor (GMF), and patients requiring intensive care unit (ICU) admission. The ATS, in contrast, stratifies patients into four major groups based on the presence of two cardiopulmonary diseases, certain modifying risk factors that increase the likelihood of acquiring specific infections (such as with drug-resistant Streptococcus pneumoniae, enteric gram-negative organisms, or Pseudomonas aeruginosa), and also based on the site of treatment (such as outpatient setting, GMF, and ICU).
社区获得性肺炎(CAP)是全球主要的死亡原因之一,在美国是第六大常见死因。它是美国传染病致死的首要原因。本文回顾了两个主要组织——美国传染病学会(IDSA)和美国胸科学会(ATS)的最新指南。IDSA将患者分为三类,并根据分类推荐抗生素治疗方案:门诊患者、入住普通内科病房(GMF)的患者以及需要入住重症监护病房(ICU)的患者。相比之下,ATS根据两种心肺疾病的存在情况、某些增加特定感染(如耐多药肺炎链球菌、肠道革兰氏阴性菌或铜绿假单胞菌感染)可能性的修正风险因素,以及治疗地点(如门诊、GMF和ICU),将患者分为四大类。