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Aug 15, 2019 Issue
Identifying Outpatients with Acute Cough at Very Low Risk of Pneumonia [Point-of-Care Guides]
In patients with acute cough, is it possible to identify a subset with a very low likelihood of community-acquired pneumonia?
When is it safe to treat a patient with community-acquired pneumonia a an outpatient?
The pathogens that cause community-acquired pneumonia are increasingly varied, and common diagnostic methods are unlikely to identify many of them. Clinical suspicion, patient risk factors, and validated scoring systems are available to guide initial management decisions and selection of therapy.
Studies show that 1 in 20 patients avoided mechanical ventilation and 1 in 16 patients avoided ARDS; 1 in 29 patients developed hyperglycemia requiring treatment. Read more.
Moderate-quality to high-quality evidence suggests that steroids, when added to antibiotics and usual care, can improve outcomes in the treatment of CAP. Benefits include reduced hospital length of stay, decreased time to clinical stability, and lower rates of mechanical ventilation and acute respiratory distress syndrome.
How does pneumonia present clinically in these patients? How is the diagnosis confirmed? What is the recommended timing and duration of antibiotic therapy? Which patients should be transferred to the hospital? Review the answers to these questions and more.
New guidelines in pneumococcal immunization policy reflect evidence for the expansion of PCV13 to persons older than 65 years and to some high-risk younger adults, and afford the opportunity to improve the health of adults.
Among patients hospitalized with CAP, adjunctive prednisone speeds time to recovery by 1.5 days and shortens hospital length of stay by approximately one day, but produces no difference in pneumonia complications at 30 days.
In this noninferiority trial, monotherapy with a beta-lactam was not as effective as combination therapy with a beta-lactam and a macrolide for achieving clinical stability in seven days for hospitalized patients with moderately severe CAP.
After all these years of knowing about Mycoplasma pneumoniae as a cause of lower respiratory tract infections and the effectiveness of various antibiotics against it in a Petri dish, we still do not know whether treating mycoplasma pneumonia in children is effective. This study does not tell us to s...