Talwar Arunabh, Lee Hans, Fein Alan
Department of Medicine, North Shore University Hospital, Manhasset, New York 11030, USA.
Curr Opin Pulm Med. 2007 May;13(3):177-85. doi: 10.1097/MCP.0b013e3280f6cf02.
Community-acquired pneumonia is associated with significant morbidity and mortality and is the most common cause of death from infectious diseases in North America. The purpose of this review is to highlight recent advances in epidemiology, risk factors, severity criteria and antibiotic therapeutic regimens used for community-acquired pneumonia management.
All guidelines recommend early and appropriate empiric therapy directed against common typical organisms, such as Streptococcus pneumoniae, and other atypical organisms, but clinicians should be aware of newer emerging pathogens such as community-acquired methicillin-resistant Staphylococcus aureus and Gram-negative pathogens.
The optimum outcome in community-acquired pneumonia can be achieved by careful risk stratification using prediction rules together with appropriate antibiotic regimens. The mainstay of community-acquired pneumonia prevention is influenza and pneumococcal immunization. Promotion of smoking cessation will also help curtail the incidence of pneumococcal disease.
社区获得性肺炎与严重的发病率和死亡率相关,是北美传染病死亡的最常见原因。本综述的目的是强调社区获得性肺炎管理在流行病学、危险因素、严重程度标准和抗生素治疗方案方面的最新进展。
所有指南都推荐针对常见典型病原体(如肺炎链球菌)和其他非典型病原体进行早期和适当的经验性治疗,但临床医生应注意新出现的病原体,如社区获得性耐甲氧西林金黄色葡萄球菌和革兰氏阴性病原体。
通过使用预测规则进行仔细的风险分层以及适当的抗生素方案,可以实现社区获得性肺炎的最佳治疗效果。社区获得性肺炎预防的主要措施是流感和肺炎球菌免疫接种。促进戒烟也将有助于降低肺炎球菌疾病的发病率。