Antibiotic therapy, supportive treatment and management of immunomodulation-inflammation response in community acquired pneumonia: review of recommendations

Abstract

Community-acquired pneumonia is a common and serious disease, with high rates of morbidity and mortality. Management and treatment of community-acquired pneumonia are described in three main documents: the 2007 American Thoracic Society guidelines, the 2011 European Respiratory Society guidelines, and the 2009 British Thoracic Society guidelines, updated by the NICE in 2015. Despite the validity of current guidelines in improving prognosis and management of patients with community-acquired pneumonia, not all recommendations have high levels of evidence and there are still some controversial issues. In particular, there are some areas of low evidence such as the efficacy of an antibiotic molecule or scheme in patients with same risk factors; duration of antibiotic treatment, supportive therapy for acute respiratory failure and immunomodulation molecules.This review will summarize the main recommendations with high level of evidence and discuss the recommendations with lower evidence, analyzing the studies published after the guidelines’ release.

Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia

“…Community-acquired pneumonia (CAP) cases constitute a significant number of intensive care hospitalizations. 1 Moreover, CAP is an important cause of mortality and morbidity in all age groups. 2 In the 2009 update of the British Thoracic Society guidelines, CAP was defined as:…”

“…Community-acquired pneumonia (CAP) cases constitute a significant number of intensive care hospitalizations. 1 Moreover, CAP is an important cause of mortality and morbidity in all age groups. 2 In the 2009 update of the British Thoracic Society guidelines, CAP was defined as: Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia (c) Signs of systemic disease (fever > 38°C and/or sweating, fever, chills, and pain); (d) There is no other explanation for the illness.…”

Most common aetiology of pneumonia among children hospitalized in the University Children’ s Hospital in Lublin, Poland, 2010–2020

“…In 1.8% of all pneumonia cases there was notable a tendency to rehospitalization within 30 days due to recurrence of the disease [7]. Treatment of both mild and moderate cases of pneumonia included not only supportive care, but also antibiotics [18]. From 83% -98% of hospitalized paediatric patients received antibiotic therapy mainly based on oral antibiotics (81.1%) [14,19].…”

Management of community-acquired bacterial pneumonia in adults: Limitations of current antibiotics and future therapies

“…Availability of antibiotic treatment guidelines based on local pathogen isolation and susceptibility patterns is essential to guide empirical antibiotic therapy in CABP. [44]…”