1. Improving outcomes in community-acquired pneumonia
- Author
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Michael S. Niederman and Michael T. Bender
- Subjects
Methicillin-Resistant Staphylococcus aureus ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,MEDLINE ,Disease ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Community-acquired pneumonia ,medicine ,Humans ,030212 general & internal medicine ,Infectious disease (athletes) ,Intensive care medicine ,Cause of death ,business.industry ,Remission Induction ,Pneumonia ,Prognosis ,medicine.disease ,Methicillin-resistant Staphylococcus aureus ,Anti-Bacterial Agents ,Community-Acquired Infections ,030228 respiratory system ,business - Abstract
Purpose of review Community-acquired pneumonia (CAP) is a pervasive disease that is encountered in outpatient and inpatient settings. CAP is the leading cause of death from an infectious disease and accounts for significant worldwide morbidity and mortality. This update reviews current advances that can be used to promote improved outcomes in CAP. Recent findings Early recognition of CAP and its severe presentations, with appropriate site of care decisions, leads to reduced patient mortality. In addition to traditional prognostic tools, certain serum biomarkers can assist in defining disease severity and guide treatment and management strategies. The use of macrolides as part of combination antibiotic therapy has shown beneficial mortality effects across the CAP disease spectrum, especially for those with severe illness. When treating community-associated, methicillin-resistant Staphylococcus aureus pneumonia, use of an antitoxin antibiotic is likely to be valuable. Adjunctive therapy with corticosteroids may prevent delayed clinical resolution in selected patients with severe CAP. Recent data expand on the interaction of CAP with comorbid disease, particularly cardiovascular disease, and its impact on mortality in CAP patients. Summary Improved diagnostic tools, optimized treatment regimens, and enhanced understanding of CAP-induced perturbations in comorbid disease states hold promise to improve patient outcomes.
- Published
- 2016
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