Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.

成人社区获得性肺炎的诊断和治疗.美国胸科学会和美国传染病学会的官方临床实践指南。

• 影响指数: 30.528
• 发表时间: 10 2019 1
• 来源期刊: Am J Respir Crit Care Med
• DOI: 10.1164/rccm.201908-1581ST
• PMID: 31573350
• 文章类型: Journal Article
• 中科院分区: Q1
• 方向: 医学
• 作者列表: Metlay JP,Waterer GW,Long AC,Anzueto A,Brozek J,Crothers K,Cooley LA,Dean NC,Fine MJ,Flanders SA,Griffin MR,Metersky ML,Musher DM,Restrepo MI,Whitney CG

关键词: community-acquired pneumonia; pneumonia; patient management

Mesh: Adult; Ambulatory Care; Anti-Bacterial Agents / therapeutic use; Antigens, Bacterial / urine; Blood Culture; Chlamydophila Infections / diagnosis drug therapy metabolism; Community-Acquired Infections / diagnosis drug therapy; Culture Techniques; Drug Therapy, Combination; Haemophilus Infections / diagnosis drug therapy metabolism; Hospitalization; Humans; Legionellosis / diagnosis drug therapy metabolism; Macrolides / therapeutic use; Moraxellaceae Infections / diagnosis drug therapy metabolism; Pneumonia, Bacterial / diagnosis drug therapy; Pneumonia, Mycoplasma / diagnosis drug therapy metabolism; Pneumonia, Pneumococcal / diagnosis drug therapy metabolism; Pneumonia, Staphylococcal / diagnosis drug therapy metabolism; Radiography, Thoracic; Severity of Illness Index; Sputum; United States; beta-Lactams / therapeutic use

Abstract

Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia.Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.Results: The panel addressed 16 specific areas for recommendations spanning questions of diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions.Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.

摘要

背景：本文提供了有关成年社区获得性肺炎患者管理的循证临床实践指南。方法：多学科小组对相关研究和建议的应用分级进行了务实的系统评价，评估,发展,和临床建议的评价方法。结果：小组讨论了16个具体领域的建议，涉及诊断测试的问题，确定护理地点，初始经验性抗生素治疗的选择，以及随后的管理决策。尽管一些建议与2007年指南保持不变，新的治疗试验和流行病学调查的结果的可用性导致了对经验性治疗策略和其他管理决定的修订建议.结论：小组制定并提供了针对成年社区获得性肺炎患者的选定诊断和治疗策略的建议依据。