Adler Nr, Weber Hm, Gunadasa I, Hughes Aj, Friedman Nd
School of Medicine, Deakin University, Geelong, Victoria, Australia.
Departments of General Medicine and Infectious Diseases, Barwon Health, Geelong, Victoria, Australia.
Clin Med Insights Circ Respir Pulm Med. 2014 Sep 14;8:17-20. doi: 10.4137/CCRPM.S17978. eCollection 2014.
Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality, particularly in elderly patients, and is associated with a considerable economic burden on the healthcare system. The combination of high incidence and substantial financial costs necessitate accurate diagnosis and appropriate management of patients admitted with CAP. This article will discuss the rates of adherence to clinical guidelines, the use of severity scoring tools and the appropriateness of antimicrobial prescribing for patients diagnosed with CAP. The authors maintain that awareness of national and hospital guidelines is imperative to complement the physicians' clinical judgment with evidence-based recommendations. Increased use of pneumonia severity assessment tools and greater adherence to therapeutic guidelines will enhance concordant antimicrobial prescribing for patients with CAP. A robust and multifaceted educational intervention, in combination with antimicrobial stewardship programs, may enhance compliance of CAP guidelines in clinical practice in Australia.
社区获得性肺炎（CAP）是发病和死亡的重要原因，尤其是在老年患者中，并且给医疗系统带来了相当大的经济负担。高发病率和巨大的经济成本相结合，使得对CAP住院患者进行准确诊断和恰当管理成为必要。本文将讨论对临床指南的遵循率、严重程度评分工具的使用以及对诊断为CAP的患者进行抗菌药物处方的合理性。作者认为，了解国家和医院指南对于用循证推荐补充医生的临床判断至关重要。增加肺炎严重程度评估工具的使用以及更好地遵循治疗指南，将提高对CAP患者进行一致的抗菌药物处方。一项强有力且多方面的教育干预措施，结合抗菌药物管理计划，可能会提高澳大利亚临床实践中对CAP指南的依从性。
