van den Broek P J
Leids Universitair Medisch Centrum, afd. Infectieziekten, C5-P, Postbus 9600, 2300 RC Leiden.
Ned Tijdschr Geneeskd. 2005 Nov 5;149(45):2492-4.
Recently, two Dutch guidelines were published regarding the management of patients with community-acquired pneumonia. In the Dutch Working Party on Antibiotic Policy (SWAB) guideline, the choice of antibiotic is based primarily on the severity of illness. In the Dutch Thoracic Society (NVALT) guideline, patients are differentiated for empiric therapy based on clinical and rapidly-available laboratory information, placing severely-ill patients in a separate category. Rapid tests for detection of Legionella pneumophila antigen have a prominent place in both guidelines. Contrary to the NVALT guideline, the SWAB guideline does not value Gram staining of sputum when selecting an initial therapeutic choice. The antibiotics recommended in the guidelines differ. Clinicians should take notice of both guidelines and take the best from each to formulate their own personal approach to patients with community-acquired pneumonia.
最近，荷兰发布了两份关于社区获得性肺炎患者管理的指南。在荷兰抗生素政策工作组（SWAB）指南中，抗生素的选择主要基于疾病的严重程度。在荷兰胸科学会（NVALT）指南中，根据临床和快速可得的实验室信息对患者进行经验性治疗区分，将重症患者单独分类。检测嗜肺军团菌抗原的快速检测在两份指南中都占有重要地位。与NVALT指南相反，SWAB指南在选择初始治疗方案时不重视痰涂片革兰氏染色。两份指南中推荐的抗生素有所不同。临床医生应关注这两份指南，并汲取各自的优点，以制定针对社区获得性肺炎患者的个人治疗方法。
