Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review.

Autores de IIS La Fe

• Miguel Salavert Lletí

  Autor

• Rafael Canton Moreno

  Autor

• Emilio Maseda Garrido

  Autor

• Rosario Menéndez Villanueva

  Autor

• Eva Polverino

  Autor

• Susana Sancho Chinesta

  Autor

• Leticia Serrano Lázaro

  Autor

Participantes ajenos a IIS La Fe

• Candel, Francisco Javier
• Basaras, Miren
• Borges, Marcio
• Cercenado, Emilia
• Cilloniz, Catian
• Estella, Angel
• Garcia-Lechuz, Juan M.
• Garnacho Montero, Jose
• Gordo, Federico
• Julian-Jimenez, Agustin
• Martin-Sanchez, Francisco Javier
• Matesanz, Mayra
• Miron-Rubio, Manuel
• Ortiz de Lejarazu, Raul
• Retamar-Gentil, Pilar
• Ruiz-Iturriaga, Luis Alberto

Grupos

• Infección Grave

• Infecciones Respiratorias

Abstract

Community-acquired pneumonia represents the third-highest cause of mortality in industrialized countries and the first due to infection. Although guidelines for the approach to this infection model are widely implemented in international health schemes, information continually emerges that generates controversy or requires updating its management. This paper reviews the most important issues in the approach to this process, such as an aetiologic update using new molecular platforms or imaging techniques, including the diagnostic stewardship in different clinical settings. It also reviews both the Intensive Care Unit admission criteria and those of clinical stability to discharge. An update in antibiotic, in oxygen, or steroidal therapy is presented. It also analyzes the management out-of-hospital in CAP requiring hospitalization, the main factors for readmission, and an approach to therapeutic failure or rescue. Finally, the main strategies for prevention and vaccination in both immunocompetent and immunocompromised hosts are reviewed.

Keywords

• community acquired pneumonia; aetiology; radiologic findings; management; readmission; hospital at home; therapeutic failure; vaccination