Memish Z A, Arabi Y M, Ahmed Q A, Shibl A M, Niederman M S
Department of Infection Prevention and Control, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
J Chemother. 2007 Oct;19 Suppl 1:33-46. doi: 10.1080/1120009x.2007.11782432.
Risk factors identify likelihood and severity of community-acquired pneumonia (CAP) and may allow prognostication. Prognostic factors can focus resources and efforts on those who may need special observation. Several risk assessment tools are used to estimate the severity of CAP and whether these tools can be used to predict outcomes, to determine disposition or even used to determine ICU level of care is hotly under debate. Treating CAP depends on age and comorbidities, as well as local epidemiology and disease severity. The current guidelines for managing CAP categorize patients with CAP into the healthy outpatient, the outpatient with modifying factors or comorbidities, the inpatient with CAP and patients requiring intensive care unit admission. These guidelines took into account regional bacteriology, antibiotic resistance data and available antibiotics to formulate recommendations. Preventive strategies for CAP include the administration of pneumococcal and influenza vaccine in selected populations at risk.
风险因素可确定社区获得性肺炎（CAP）的可能性和严重程度，并可能有助于进行预后评估。预后因素可将资源和精力集中于那些可能需要特殊观察的患者。几种风险评估工具用于估计CAP的严重程度，而这些工具是否可用于预测结局、确定治疗方案甚至用于确定重症监护病房的护理级别，目前仍存在激烈争论。治疗CAP取决于年龄、合并症，以及当地的流行病学情况和疾病严重程度。当前管理CAP的指南将CAP患者分为健康门诊患者、有修正因素或合并症的门诊患者、CAP住院患者以及需要入住重症监护病房的患者。这些指南考虑了区域细菌学、抗生素耐药性数据和可用抗生素，以制定建议。CAP的预防策略包括在选定的高危人群中接种肺炎球菌疫苗和流感疫苗。
