[Rational means of the determination of costs and etiological diagnosis of community-acquired pneumonia].

The cost and effectiveness of examinations (sputum staining and culturing, antitest determination for Influenza A and B, RSV, Adenovirus, Chlamydia psittaci and pneumoniae, Coxiella burnetii, Mycoplasma pneumoniae and Legionella pneumophila, and determination for Streptococcus pneumoniae antigen) performed to explore the aetiology of community-acquired pneumonia in the case of 258 hospitalised patients were analysed. The aetiology could be determined in 44.2% of the cases. On the basis of prevailing prices in 1986-88 one pneumonia case with determinable aetiology costs 8111 Forint. The authors have come to the conclusion that in the present epidemiological situation in this country it is not worthwhile to look for so-called non-bacterial microorganisms routinely, because of their rarely occurrence (16.7%) the cost per one positive finding is unrealistically high. Comparing the cost and the practical use the examinations applied the rational choice seems to be to culture the sputum with deep airway origin and to determine the Streptococcus pneumoniae antigen routinely. In the case of suspicion of non-bacterial origin to perform complement fixation test for Mycoplasma pneumoniae and in a severe clinical state to culture the blood is recommended.