Matches in SemOpenAlex for { <https://semopenalex.org/work/W1070905937> ?p ?o ?g. }
- W1070905937 endingPage "537" @default.
- W1070905937 startingPage "519" @default.
- W1070905937 abstract "Community-acquired pneumonia (CAP) is a common infectious disease that still causes substantial morbidity and mortality. Elderly people are frequently affected, and several issues related to care of this condition in the elderly have to be considered. This article reviews current recommendations of guidelines with a special focus on aspects of the care of elderly patients with CAP. The most common pathogen in CAP is still Streptococcus pneumoniae, followed by other pathogens such as Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella species. Antimicrobial resistance is an increasing problem, especially with regard to macrolide-resistant S. pneumoniae and fluoroquinolone-resistant strains. With regard to β-lactam antibacterials, resistance by H. influenzae and Moraxella catarrhalis is important, as is the emergence of multidrug-resistant Staphylococcus aureus. The main management decisions should be guided by the severity of disease, which can be assessed by validated clinical risk scores such as CURB-65, a tool for measuring the severity of pneumonia based on assessment of confusion, serum urea, respiratory rate and blood pressure in patients aged ≥65 years. For the treatment of low-risk pneumonia, an aminopenicillin such as amoxicillin with or without a β-lactamase inhibitor is frequently recommended. Monotherapy with macrolides is also possible, although macrolide resistance is of concern. When predisposing factors for special pathogens are present, a β-lactam antibacterial combined with a β-lactamase inhibitor, or the combination of a β-lactam antibacterial, a β-lactamase inhibitor and a macrolide, may be warranted. If possible, patients who have undergone previous antibacterial therapy should receive drug classes not previously used. For hospitalized patients with non-severe pneumonia, a common recommendation is empirical antibacterial therapy with an aminopenicillin in combination with a β-lactamase inhibitor, or with fluoroquinolone monotherapy. With proven Legionella pneumonia, a combination of β-lactams with a fluoroquinolone or a macrolide is beneficial. In severe pneumonia, ureidopenicillins with β-lactamase inhibitors, broad-spectrum cephalosporins, macrolides and fluoroquinolones are used. A combination of a broad-spectrum β-lactam antibacterial (e.g. cefotaxime or ceftriaxone), piperacillin/tazobactam and a macrolide is mostly recommended. In patients with a predisposition for Pseudomonas aeruginosa, a combination of piperacillin/tazobactam, cefepime, imipenem or meropenem and levofloxacin or ciprofloxacin is frequently used. Treatment duration of more than 7 days is not generally recommended, except for proven infections with P. aeruginosa, for which 15 days of treatment appears to be appropriate. Further care issues in all hospitalized patients are timely administration of antibacterials, oxygen supply in case of hypoxaemia, and fluid management and dose adjustments according to kidney function. The management of elderly patients with CAP is a challenge. Shifts in antimicrobial resistance and the availability of new antibacterials will change future clinical practice. Studies investigating new methods to detect pathogens, determine the optimal antimicrobial regimen and clarify the duration of treatment may assist in further optimizing the management of elderly patients with CAP." @default.
- W1070905937 created "2016-06-24" @default.
- W1070905937 creator A5005003327 @default.
- W1070905937 creator A5018387556 @default.
- W1070905937 creator A5052162364 @default.
- W1070905937 date "2011-07-01" @default.
- W1070905937 modified "2023-10-12" @default.
- W1070905937 title "Elderly Patients with Community-Acquired Pneumonia" @default.
- W1070905937 cites W1479672098 @default.
- W1070905937 cites W178113207 @default.
- W1070905937 cites W1843993979 @default.
- W1070905937 cites W1960495543 @default.
- W1070905937 cites W1963651669 @default.
- W1070905937 cites W1963980193 @default.
- W1070905937 cites W1965826987 @default.
- W1070905937 cites W1968427335 @default.
- W1070905937 cites W1969474169 @default.
- W1070905937 cites W1971170665 @default.
- W1070905937 cites W1976044196 @default.
- W1070905937 cites W1976655580 @default.
- W1070905937 cites W1977679888 @default.
- W1070905937 cites W1978245176 @default.
- W1070905937 cites W1980580723 @default.
- W1070905937 cites W1981685245 @default.
- W1070905937 cites W1981947129 @default.
- W1070905937 cites W1982803182 @default.
- W1070905937 cites W1989424168 @default.
- W1070905937 cites W1989551128 @default.
- W1070905937 cites W1993180775 @default.
- W1070905937 cites W1993861560 @default.
- W1070905937 cites W1994081382 @default.
- W1070905937 cites W1994403485 @default.
- W1070905937 cites W1995231765 @default.
- W1070905937 cites W1999614024 @default.
- W1070905937 cites W2001205514 @default.
- W1070905937 cites W2001437624 @default.
- W1070905937 cites W2001564186 @default.
- W1070905937 cites W2003572900 @default.
- W1070905937 cites W2004449157 @default.
- W1070905937 cites W2006389278 @default.
- W1070905937 cites W2010913508 @default.
- W1070905937 cites W2011702210 @default.
- W1070905937 cites W2013033629 @default.
- W1070905937 cites W2013636108 @default.
- W1070905937 cites W2014775960 @default.
- W1070905937 cites W2015372428 @default.
- W1070905937 cites W2019154723 @default.
- W1070905937 cites W2019336526 @default.
- W1070905937 cites W2023863717 @default.
- W1070905937 cites W2027453508 @default.
- W1070905937 cites W2028702587 @default.
- W1070905937 cites W2029733998 @default.
- W1070905937 cites W2033542880 @default.
- W1070905937 cites W2037702987 @default.
- W1070905937 cites W2041285421 @default.
- W1070905937 cites W2042136249 @default.
- W1070905937 cites W2044455259 @default.
- W1070905937 cites W2046415153 @default.
- W1070905937 cites W2046425627 @default.
- W1070905937 cites W2046931687 @default.
- W1070905937 cites W2052439141 @default.
- W1070905937 cites W2052601383 @default.
- W1070905937 cites W2055855217 @default.
- W1070905937 cites W2055864845 @default.
- W1070905937 cites W2057598887 @default.
- W1070905937 cites W2060112840 @default.
- W1070905937 cites W2061241079 @default.
- W1070905937 cites W2064595357 @default.
- W1070905937 cites W2064726816 @default.
- W1070905937 cites W2070185949 @default.
- W1070905937 cites W2077441600 @default.
- W1070905937 cites W2078901116 @default.
- W1070905937 cites W2079382261 @default.
- W1070905937 cites W2080037059 @default.
- W1070905937 cites W2081798257 @default.
- W1070905937 cites W2082387619 @default.
- W1070905937 cites W2082398646 @default.
- W1070905937 cites W2082404411 @default.
- W1070905937 cites W2086909504 @default.
- W1070905937 cites W2091977057 @default.
- W1070905937 cites W2094420308 @default.
- W1070905937 cites W2096497624 @default.
- W1070905937 cites W2097408199 @default.
- W1070905937 cites W2098324922 @default.
- W1070905937 cites W2100154890 @default.
- W1070905937 cites W2100187026 @default.
- W1070905937 cites W2100193713 @default.
- W1070905937 cites W2101616611 @default.
- W1070905937 cites W2102361557 @default.
- W1070905937 cites W2103581299 @default.
- W1070905937 cites W2104346641 @default.
- W1070905937 cites W2104627818 @default.
- W1070905937 cites W2105795595 @default.
- W1070905937 cites W2107518657 @default.
- W1070905937 cites W2107932739 @default.
- W1070905937 cites W2111513587 @default.
- W1070905937 cites W2111802080 @default.
- W1070905937 cites W2112329842 @default.