Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review

Abstract

Community-acquired pneumonia represents the third-highest cause of mortality in industrialized countries and the first due to infection. Although guidelines for the approach to this infection model are widely implemented in international health schemes, information continually emerges that generates controversy or requires updating its management. This paper reviews the most important issues in the approach to this process, such as an aetiologic update using new molecular platforms or imaging techniques, including the diagnostic stewardship in different clinical settings. It also reviews both the Intensive Care Unit admission criteria and those of clinical stability to discharge. An update in antibiotic, in oxygen, or steroidal therapy is presented. It also analyzes the management out-of-hospital in CAP requiring hospitalization, the main factors for readmission, and an approach to therapeutic failure or rescue. Finally, the main strategies for prevention and vaccination in both immunocompetent and immunocompromised hosts are reviewed.

Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023

“…New documents driven by Spanish medical societies . Eleven medical societies collaborated in 2022 to prepare two documents to actualize knowledge about CAP, HAP, and VAP [ 17 , 18 ]. These societies were GEIPC-SEIMC (critical patient infection study group, Spanish Society of Clinical Microbiology and Infectious Diseases), SEQ (Spanish Society of Chemotherapy), Infurgsemes-SEMES (Emergency Department Infection Study Group, Spanish Society of Emergency Medicine), GEVAC-SEIMC (Vaccines Study Group, Spanish Society of Clinical Microbiology and Infectious Diseases), GTEIS-SEMICYUC (Working Group on Infectious Diseases and Sepsis-Spanish Society of Intensive Care Medicine, Critical Care and Coronary Units), GEMARA-SEIMC (Task Force on Mechanisms of Action and Antimicrobial Resistance, Spanish Society of Clinical Microbiology and Infectious Diseases), GEIRAS-SEIMC (Healthcare-associated Infection Study Group, Spanish Society of Clinical Microbiology and Infectious Diseases), SEPAR (Spanish Society of Pneumology and Thoracic Surgery), SEGG (Spanish Society of Geriatrics and Gerontology), SEDAR-GTIPO (Perioperative Infections Task Force, Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy), and SEHAD (Spanish Society of Hospital at Home).…”