Rodríguez WF, Monteón BI, Pérez PI, Sáez TG, López TG

Language: Spanish
References: 12
Page: 271-276
PDF size: 148.11 Kb.

ABSTRACT

Background: Community acquired pneumonia is an infectious disease of the pulmonary parenchyma in association to symptoms of acute illness and signs on auscultation compatible with pneumonia and pulmonary infiltrates on chest radiograph.
Objective: To determine a conduct of patients with community acquired pneumonia in Hospital Angeles del Pedregal.
Material and methods: A retrospective, descriptive, and observational study was made in the patients who entered to the service of urgencies with diagnosis of community acquired pneumonia. The period of study was from January 1st to December 31^st of 2005.
Results: 93 patients registered themselves (39 men and 54 women), whose average of age was 66.3 years. The more frequent factors of risk included 26 patients with previous neumopaties (EPOC was the commonest), 32 with tabaquism antecedent, 16 with diabetes. The election treatment, when entering the hospital, consists of third generation cephalosporin (26 patients), levofloxacin (14 patients) and the combination of third generation cephalosporin and claritromicin (8 patients). Only in 12 patients the initial treatment due to the results of antibiogram was modified. Of the 93 hospitalized patients, 39 withdrew in response to the treatment.
Conclusion: Patients older than 60 years of age have high risk factor to develop neumonia acquired in the community. In several occasions, the decision of the treatment is made with the indications in The American Thoracic Society and The Infectious Disease Society of America guides. The culture of the expectorations is useful to select or to change the antibiotic treatment; nevertheless, not always it is sustained by this antibiogram or the clinical evolution of the patient.

REFERENCES

1. Bartlett JG, Dowell SF, Mandell LA, File TM, et al. Practice guidelines for management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis 2000;31:347-82.

2. Shah PB, Giudice JC, Griesback R, Morley TF, Vasoya A. The newer guidelines for the management of community acquired pneumonia. J Am Osteopath Assoc 2004;104(12):521-6.

3. European Study on Community-Acquired Pneumonia (ESOCAP) Committee. Guidelines for management of adult community- acquired lower respiratory tract infections. Eur Respir J 1998;11:986-91.

4. Alfageme I, Aspa S, Bello J, Blanquer R, et al. Guidelines for the diagnosis and treatment of community-acquired pneumonia. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). Arch Broncoeumol 2005;41(5):272-89.

5. Sansores MRH, Acuña KM, Castañeda GR, Castillo SFJ, et al. Consenso Nacional de Uso de Antimicrobianos en la Neumonía Adquirida en la Comunidad. Neumol Cir Torax 2004;63(2):67-78.

6. Mandell LA. Epidemiology and etiology of community acquided pneumonia. Infect Dis Clin N Am 2004;18:761-76.

7. Niederman MS, Mandell LA, Anzuelo A, Bass JB, et al. Guidelines for the management of adults with communityacquired pneumonia. Diagnosis, assesment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 2001;163:1730-54.

8. Mandell LA, Marrie TJ, Grossman RF, Chow AW, Hyland RH. Canadian guidelines for the initial management of community- acquired pneumonia: an evidence-based update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society. The Canadian Community-Acquired Pneumonia Working Group. Clin Infect Dis 2000;31:383-421.

9. File TM, Garau J, Blasi F, Chidiac C, et al. Guidelines for empiric antimicrobial prescribing in community-acquired pneumonia. Chest 2004;125;1888-1901.

10. British Thoracic Society Standards of Care Committee. Guidelines for the management of community-acquired pneumonia in adults. Thorax 2001;56(suppl 4):1-64.

11. Hasnain M, Clark EJ. Management strategies for community acquired pneumonia. J Med Syst 2000;24:279-88.

12. Flanders SA, Halm EA. Guidelines for community-acquired pneumonia: are they reflected in practice? Treat Respir Med 2004;3(2):7-77.