Abstract:
Pneumonia is a multifaceted illness with a wide range of clinical manifestations, degree of severity and multiple potential causing microorganisms. Despite the intensive research of recent decades, community-acquired pneumonia remains the third-highest cause of mortality in developed countries and the first due to infections; and hospital-acquired pneumonia is the main cause of death from nosocomial infection in critically ill patients. Guidelines for management of this disease are available world wide, but there are questions which generate controversy, and the latest advances make it difficult to stay them up to date. A multidisciplinary approach can overcome these limitations and can also aid to improve clinical results. Spanish medical societies involved in diagnosis and treatment of pneumonia have made a collaborative effort to actualize and integrate last expertise about this infection. The aim of this paper is to reflect this knowledge, communicated in Fifth Pneumonia Day in Spain. It reviews the most important questions about this disorder, such as microbiological diagnosis, advances in antibiotic and sequential therapy, management of beta-lactam allergic patient, preventive measures, management of unusual or multi-resistant microorganisms and adjuvant or advanced therapies in Intensive Care Unit.
摘要:
肺炎是一种多方面的疾病,临床表现广泛,严重程度和多种潜在的致病微生物。尽管近几十年来进行了深入的研究,在发达国家,社区获得性肺炎仍然是第三大死亡原因,也是第一大由感染引起的死亡原因;而医院获得性肺炎是危重患者医院感染导致死亡的主要原因.这种疾病的管理指南在世界各地都有,但是有些问题会引起争议,和最新的进展使他们很难保持最新。多学科方法可以克服这些限制,也可以帮助改善临床结果。参与肺炎诊断和治疗的西班牙医学协会已共同努力,以实现和整合有关这种感染的最新专业知识。本文的目的是反映这些知识,在西班牙的第五个肺炎日。它回顾了关于这种疾病的最重要的问题,如微生物学诊断,抗生素和序贯疗法的进展,β-内酰胺过敏患者的管理,预防措施,在重症监护病房中管理异常或多重抗性微生物以及辅助或高级疗法。