Witte L, Drömann D
Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Med Klin Intensivmed Notfmed. 2012 Mar;107(2):151-8; quiz 159. doi: 10.1007/s00063-012-0094-1. Epub 2012 Mar 11.
Severe community-acquired pneumonia and hospital-acquired pneumonia are common infectious diseases in Germany. They are associated with high mortality especially in the old and multimorbid patient and are thus a challenge in daily clinical practice. While the CRB65 is a thoroughly validated score for risk stratification in community-acquired pneumonia, there is no comparable score for hospital-acquired pneumonia yet. Early initiation of adequate antibiotic treatment is essential for a positive outcome. Hospital-acquired pneumonia is more often associated with multidrug-resistant bacteria, which should be considered in the choice of initial treatment especially if the patient can be considered a member of a risk group. This article focuses on severe pneumonia and gives an overview of the recent guidelines and discusses newly published results.
重症社区获得性肺炎和医院获得性肺炎在德国是常见的传染病。它们与高死亡率相关，尤其是在老年和患有多种疾病的患者中，因此在日常临床实践中是一项挑战。虽然CRB65是用于社区获得性肺炎风险分层的经过充分验证的评分，但目前尚无用于医院获得性肺炎的类似评分。尽早开始适当的抗生素治疗对于取得良好结果至关重要。医院获得性肺炎更常与多重耐药菌相关，在选择初始治疗时应予以考虑，尤其是当患者可被视为风险群体成员时。本文重点关注重症肺炎，概述了近期指南并讨论了新发表的结果。
