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Curr Opin Crit Care · Oct 2016
ReviewCommunity-acquired pneumonia: still a major burden of disease.
- Charles Feldman and Ronald Anderson.
- aCharlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, JohannesburgbInstitute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
- Curr Opin Crit Care. 2016 Oct 1; 22 (5): 477-84.
Purpose Of ReviewDescribe recent studies that may impact on the management of community-acquired pneumonia (CAP).Recent FindingsCAP continues to be associated with a considerable burden of disease. Diagnosis remains problematic, and various biomarkers are neither accurate in the diagnosis of the presence of CAP nor superior to standard severity of illness scores in predicting outcome. Current evidence indicates that patients with nonsevere CAP can be effectively treated with antibiotic monotherapy, whereas those with severe infection, particularly ICU cases, do best with early initiation of combination antibiotic therapy. Several studies have investigated anti-inflammatory, adjunctive therapies for severe CAP, with corticosteroids appearing to be most promising. It is well recognized that cardiac complications occur during the course of CAP, being associated with poorer short-term and long-term outcomes, prompting considerable interest in the adjunctive potential of statins and antiplatelet therapies. In addition to evaluating these adjunctive therapies, attention has also focused on identifying strategies that predict the need for ICU admission in patients with CAP.SummaryAlthough questions remain, particularly with regard to prediction of outcome, recent studies of CAP, both clinical and experimental, have contributed novel insights into disease pathogenesis that may enable improvement of current treatment strategies.
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