Clinical Practice Guidelines for Nursing- and Healthcare-associated Pneumonia (NHCAP) [Complete translation]

Kohno, Shigeru; Imamura, Yoshifumi; Shindo, Yuichiro; Seki, Masafumi; Ishida, Tadashi; Teramoto, Shinji; Kadota, Jun‐ichi; Tomono, Kazunori; Watanabe, Akira

doi:10.1016/j.resinv.2012.11.001

Cited by 152 publications

(213 citation statements)

References 89 publications

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“…Pneumonia is currently classified according to the place where the patient contract the infection, such as community-acquired pneumonia, hospital-acquired pneumonia, and nursing home-acquired pneumonia, which is a part of health care-associated pneumonia (1)(2)(3). In each category of pneumonia, there is at least one guideline (1)(2)(3)(4)(5)(6). The guidelines basically describe how to use antibiotics based on the idea that the pathogen is decided by the location.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia, dystussia, and aspiration pneumonia in elderly people

Ebihara¹,

Sekiya²,

Miyagi³

et al. 2016

J. Thorac. Dis.

140

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Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly people and mouse lung. These observations suggest the need for a paradigm shift of the treatment for pneumonia in the elderly. Since aspiration pneumonia is fundamentally based on dysphagia, we should shift the therapy for aspiration pneumonia from pathogen-oriented therapy to function-oriented therapy. Function-oriented therapy in aspiration pneumonia means therapy focusing on slowing or reversing the functional decline that occurs as part of the aging process, such as "dementia → dysphagia → dystussia → atussia → silent aspiration". Atussia is ultimate dysfunction of cough physiology, and aspiration with atussia is called silent aspiration, which leads to the development of life-threatening aspiration pneumonia. Research pursuing effective strategies to restore function in the elderly is warranted in order to decrease pneumonia deaths in elderly people.

show abstract

Section: Introductionmentioning

confidence: 99%

Dysphagia, dystussia, and aspiration pneumonia in elderly people

Ebihara¹,

Sekiya²,

Miyagi³

et al. 2016

J. Thorac. Dis.

140

View full text Add to dashboard Cite

show abstract

“…The Guidelines for NHCAP of the JRS recommend that antimicrobial agents be selected for patients requiring hospitalization for treatment, in consideration of the risk of the emergence of resistant bacteria. When there is no risk of such emergence, ABPC/SBT, CTRX, panipenem/betamipron (PAPM/BP), and levofloxacin (LVFX) infusion are recommended [2]. In order to treat aspiration pneumonia, ABPC/SBT is an appropriate choice of bacteriocin for oral anaerobic species (e.g., Prevotella, Micromonas), aerobes such as Streptococcus anginosus Group and S. pneumoniae.…”

Section: Discussionmentioning

confidence: 99%

“…The following data were collected from medical charts: age, sex, residence immediately before admission (e.g., home, hospital, nursing home, group home), comorbidity, past history, lifestyle history, blood test results, bacteriological test, the antimicrobial agent used in the initial treatment, outcome at the time of admission, or death (death within 30 days or termination of hospitalization due to death). Patients were classified into two groups, those with NHCAP [2] and those with CAP [14], according to the definitions of the JRS. A patient with NHCAP is defined as 1) an extended care unit resident or a nursing home resident; 2) a patient who was discharged from a hospital within 90 days; 3) an elderly patient or one with physical disabilities requiring nursing care; or 4) a patient who continues to receive endovascular treatment (treatments involving blood dialysis, antimicrobial agents, chemotherapy, or immunosuppressive agents) on an outpatient basis.…”

Section: Patients With Pneumoniamentioning

confidence: 99%

“…Due to the rapid increase in the elderly population, pneumonia became the third leading cause of death following malignancy and heart disease in 2011, and further growth is anticipated. Therefore, for the increasing number of people receiving <cared> healthcare at home or as nursing home residents, Japanese Respiratory Society (JRS) issued the Clinical Practice Guidelines for Nursing-and Healthcare-associated Pneumonia (NHCAP) [2]. The guideline described the diagnosis, the conditions under which hospitalization can be applied and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…The frequent pathogen bacteria of aspiration pneumonia include intraoral anaerobes [8][9][10], which is covered by empiric antibiotic therapy. The US guidelines of heatlth care acquired pneumonia (HCAP) [11] and NHCAP [2] state that patients with aspiration pneumonia should receive β-lactams such as ampicillin/sulbactam (ABPC/SBT) when they must be admitted to hospitals and have no risk of multidrug resistant pathogens [2,11]. In NHCAP, however, the dose and frequency of ABPC/SBT have not been examined.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Ampicillin/Sulbactam Dose and Dosing Frequency in Elderly Patients with Nursing- and Healthcare-Associated Pneumonia (Nhcap)

Yamazaki¹,

Sugawara²

2016

J Infect Dis Ther

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Japan has the most rapidly aging population in the world. This study aimed to examine the differences in the efficacy of ampicillin/sulbactam (ABPC/SBT) alone under different daily doses and daily dosing frequencies in elderly patients receiving healthcare at home and in elderly nursing home residents with pneumonia onset requiring hospitalization for treatment. By applying the Clinical Practice Guidelines for Nursing-and Healthcare-associated Pneumonia (NHCAP) of the Japanese Respiratory Society (JRS), we retrospectively analyzed clinical data, dose, dosing period, and the efficacy of antimicrobial agents, as well as outcomes of patients with NHCAP or community acquired pneumonia (CAP) who had been hospitalized at our department during the 3-year period of 2009 through 2011. The mean age of NHCAP patients (n=587) was 85 ± 9 years, significantly higher than the 77 ± 16 years of CAP patients (n=319). The serum albumin level in NHCAP patients was significantly lower than that in CAP patients. Among NHCAP patients, 82.5% received ABPC/SBT alone as the first-line therapy, with 50.7% receiving 1.5 g three times daily and 22.8% receiving 3 g twice daily. The mortality rate during hospitalization in the 1.5-g three-times-daily group was 12.4%, resulting in a significantly decrease as compared with the 3-g twice-daily group of 20.9% (p<0.01). In our study, which targeted the elderly in Japan, it was revealed that ABPC/SBT is an appropriate first choice of antibiotics in treating NHCAP and that administering 1.5 g three times daily is a suitable way of administration.

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Evaluation of swallowing function in patients with oropharyngeal secretions

Yamaguchi

Mikushi

Ayuse

2019

Clinical & Exp Dental Res

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BackgroundSeveral studies have reported a strong association between the presence of oropharyngeal secretions in the laryngeal vestibule and the likelihood of aspiration of food or liquid. However, no previous studies have evaluated the accumulation of saliva and swallowing dynamics.ObjectiveThe objective of this study was to examine the factors related to decreased function that result in saliva accumulation based on images from videofluoroscopic examination of swallowing (VF) performed on the same day as videoendoscopic examination of swallowing (VE).MethodsThis retrospective study investigated 47 patients with dysphagia who underwent VF and VE on the same day. Saliva accumulation in the pharynx was assessed on VE and classified by the Murray secretion scale. Pharyngeal residue was assessed on VF. In addition, displacement of the hyoid bone and larynx on swallowing and the opening size of the esophageal orifice were measured, and contact between the base of the tongue and the posterior pharyngeal wall was examined on VF.ResultsModerate correlations were found between saliva accumulation and perpendicular displacement of the larynx and upper esophageal sphincter opening. The percentage of patients showing contact between the base of the tongue and the posterior pharyngeal wall was significantly greater in those with a saliva accumulation score of 0 or 1.ConclusionLess laryngeal elevation and upper esophageal sphincter opening and absence of contact between the base of the tongue and the posterior pharyngeal wall when swallowing tended to result in accumulation of saliva in the pharynx.

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Clinical Practice Guidelines for Nursing- and Healthcare-associated Pneumonia (NHCAP) [Complete translation]

Cited by 152 publications

References 89 publications

Dysphagia, dystussia, and aspiration pneumonia in elderly people

Dysphagia, dystussia, and aspiration pneumonia in elderly people

Effects of Ampicillin/Sulbactam Dose and Dosing Frequency in Elderly Patients with Nursing- and Healthcare-Associated Pneumonia (Nhcap)

Evaluation of swallowing function in patients with oropharyngeal secretions

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