Challenges in severe community-acquired pneumonia: a point-of-view review.
Antoní TorresJames D ChalmersCharles S Dela CruzCristina DominedòMarin KollefIgnacio Martin-LoechesMichael NiedermanRichard G WunderinkPublished in: Intensive care medicine (2019)
The IDSA/ATS criteria remain the most pragmatic tool to predict ICU admission. The authors recommend a combination of a beta-lactam/beta-lactamase inhibitor or a third G cephalosporin plus a macrolide in most SCAP patients, and to empirically cover PES (P. aeruginosa, extended spectrum beta-lactamase producing Enterobacteriaceae, methicillin-resistant S. aureus) pathogens when at least two specific risk factors are present. In patients with influenza CAP, the authors recommend the use of oseltamivir and avoidance of the use of steroids. Corticosteroids can be used in case of refractory shock and high systemic inflammatory response.
Keyphrases
- gram negative
- inflammatory response
- risk factors
- multidrug resistant
- community acquired pneumonia
- end stage renal disease
- newly diagnosed
- staphylococcus aureus
- escherichia coli
- chronic kidney disease
- ejection fraction
- emergency department
- intensive care unit
- pseudomonas aeruginosa
- peritoneal dialysis
- randomized controlled trial
- prognostic factors
- early onset
- methicillin resistant staphylococcus aureus
- study protocol
- lps induced
- toll like receptor
- immune response
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- mechanical ventilation