Severe sepsis in community-acquired pneumonia - Early recognition and treatment

• Type: Another Publication in an International Scientific Journal
• Date: 2012

Authors

Pereira, JM (Author) Other; Paiva, J-A (Author) FMUP; Rello, J (Author) Other

Journal

Title: European Journal of Internal Medicine

Vol. 23

Pages: 412-419

ISSN: 0953-6205

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 24 Citations

Scopus - 26 Citations

Other information

Authenticus ID: P-002-8GZ

DOI: 10.1016/j.ejim.2012.04.016

Abstract (EN): Despite remarkable advances in its management, community-acquired pneumonia (CAP) remains an important cause of morbidity and mortality leading to significant consumption of health, social and economic resources. The assessment of CAP severity is a cornerstone in its management, facilitating selection of the most appropriate site of care and empirical antibiotic therapy. Several clinical scoring systems based on 30-day mortality have been developed to identify those patients with the highest risk of death. Although well validated in appropriate patient groups, each system has its own limitations and each exhibits different sensitivity and specificity values. These problems have increased interest in the use of biomarkers to predict CAP severity. Although so far no ideal solution has been identified, recent advances in bacterial genomic load quantification have made this tool very attractive. Early antibiotic therapy is essential to the reduction of CAP mortality and the selection of antibiotic treatment according to clinical guidelines is also associated with an improved outcome. In addition, the addition of a macrolide to standard empirical therapy seems to improve outcome in severe CAP although the mechanism of this is unclear. Finally, the role of adjuvant therapy has not yet been satisfactorily established. In this review we will present our opinion on current best practice in the assessment of severity and treatment of severe CAP.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8