Garb J L, Brown R B, Garb J R, Tuthill R W
JAMA. 1978 Nov 10;240(20):2169-72.
Comparison of 35 elderly patients hospitalized with pneumonia acquired in nursing homes and 35 elderly patients hospitalized with community-acquired pneumonia showed that 16 (47.1%) of the nursing home patients had received previous antibiotic therapy compared with two (5.9%) of the community patients. Klebsiella pneumoniae was isolated in 14 (40%) of the nursing home patients, but in only three (8.6%) of the community patients. Staphylococcus aureus was also more frequent in nursing home patients (nine, 25.7%) compared with community patients (five, 14.3%). Persons hospitalized with nursing home-acquired pneumonia should be treated initially with antimicrobial agents active against K pneumoniae and S aureus unless the clinical picture strongly suggests otherwise.
对35名因在疗养院获得性肺炎住院的老年患者和35名因社区获得性肺炎住院的老年患者进行比较，结果显示，16名（47.1%）疗养院患者此前接受过抗生素治疗，而社区患者中只有2名（5.9%）接受过此类治疗。14名（40%）疗养院患者分离出肺炎克雷伯菌，而社区患者中只有3名（8.6%）分离出该菌。与社区患者（5名，14.3%）相比，金黄色葡萄球菌在疗养院患者中也更常见（9名，25.7%）。除非临床表现强烈提示有其他情况，否则因疗养院获得性肺炎住院的患者应首先使用对肺炎克雷伯菌和金黄色葡萄球菌有效的抗菌药物进行治疗。
