علاج الالتهاب الرئوي بالمفطورة الرئوية في الالتهاب الرئوي الحاد المكتسب من المجتمع

References

DOI: 10.1164/rccm.201908-1581ST

• In inpatient adults with severe CAP (see Table 1) without risk factors for MRSA or P. aeruginosa, we recommend (Table 4) (note, specific agents and doses are the same as 9.1):
• Validated definition includes either one major criterion or three or more minor criteria.
• In inpatient adults with severe CAP (see Table 1) without risk factors for MRSA or P. aeruginosa, we recommend (Table 4) (note, specific agents and doses are the same as 9.1): a b-lactam plus a macrolide (strong recommendation, moderate quality of evidence); or a b-lactam plus a respiratory fluoroquinolone (strong recommendation, low quality of evidence).
• Therefore, we recommend that combination therapy with a b-lactam plus a macrolide or a b-lactam plus a respiratory fluoroquinolone should be the treatment of choice for patients with severe CAP.
• As recent data supporting antibiotic administration for <5 days are scant, on a risk–benefit basis we recommend treating for a minimum of 5 days, even if the patient has reached clinical stability before 5 days.
• We recommend that the duration of antibiotic therapy should be guided by a validated measure of clinical stability (resolution of vital sign abnormalities [heart rate, respiratory rate, blood pressure, oxygen saturation, and temperature], ability to eat, and normal mentation), and antibiotic therapy should be continued until the patient achieves stability and for no less than a total of 5 days.
• Failure to achieve clinical stability within 5 days is associated with higher mortality and worse clinical outcomes.