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Severe Community-acquired Pneumonia

  • J. Vergragt
  • J. Kesecioglu
  • D. W. de Lange
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM, volume 2012)

Abstract

Severe community-acquired pneumonia (CAP) is an important disease and on many intensive care units (ICUs) it is one of the most prevalent infectious diseases. Despite advances in antimicrobial therapy, rates of mortality from CAP remain unacceptably high. In fact, mortality rates have not decreased significantly since penicillin became routinely available and CAP remains the seventh leading cause of death in the United States [1, 2]. Estimates of the incidence of CAP range from 4 million to 5 million cases per year in the United States, with about 500,000 patients requiring hospitalization and 45,000 deaths annually [3].

Keywords

Chronic Obstructive Pulmonary Disease Severe Sepsis Prone Position Acute Respiratory Distress Syndrome Pneumonia Severity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Feikin DR, Schuchat A, Kolczak M, et al (2000) Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995–1997. Am J Public Health 90: 223–229PubMedCrossRefGoogle Scholar
  2. 2.
    Hoyert DL, Heron MP, Murphy SL, et al (2006) Deaths: final data for 2003. Natl Vital Stat Rep 54: 1–120PubMedGoogle Scholar
  3. 3.
    Brown SM, Dean NC (2010) Defining and predicting severe community-acquired pneumonia. Curr Opin Infect Dis 23: 158–164PubMedCrossRefGoogle Scholar
  4. 4.
    Welte T, Torres A, Nathwani D (2012) Clinical and economic burden of communityacquired pneumonia among adults in Europe. Thorax 67: 71–79PubMedCrossRefGoogle Scholar
  5. 5.
    Bauer TT, Welte T, Ernen C, et al (2005) Cost analyses of community-acquired pneumonia from the hospital perspective. Chest 128: 2238–2246PubMedCrossRefGoogle Scholar
  6. 6.
    Angus DC, Marrie TJ, Obrosky DS, et al (2002) Severe community-acquired pneumonia: use of intensive care services and evaluation of American and British Thoracic Society Diagnostic criteria. Am J Respir Crit Care Med 166: 717–723PubMedCrossRefGoogle Scholar
  7. 7.
    El Moussaoui R, Opmeer BC, de Borgie CA, et al (2006) Long-term symptom recovery and health-related quality of life in patients with mild-to-moderate-severe communityacquired pneumonia. Chest 130: 1165–1172PubMedCrossRefGoogle Scholar
  8. 8.
    Rodríguez A, Mendia A, Sirvent JM, et al (2007) Combination antibiotic therapy improves survival in patients with community-acquired pneumonia and shock. Crit Care Med 35: 1493–1498PubMedCrossRefGoogle Scholar
  9. 9.
    Woodhead M, Welch CA, Harrison DA, et al (2006) Community-acquired pneumonia on the intensive care unit: secondary analysis of 17,869 cases in the ICNARC Case Mix Programme Database. Crit Care 10 (Suppl 2): S 1CrossRefGoogle Scholar
  10. 10.
    Ewig S (2011) Gains and limitations of predictive rules for severe community-acquired pneumonia. Clin Infect Dis 53: 512–514PubMedCrossRefGoogle Scholar
  11. 11.
    Renaud B, Santin A, Coma E, et al (2009) Association between timing of intensive care unit admission and outcomes for emergency department patients with community acquired pneumonia. Crit Care Med 37: 2867–2874PubMedCrossRefGoogle Scholar
  12. 12.
    Restrepo MI, Mortensen EM, Rello J, et al (2010) Late admission to the ICU in patients with community-acquired pneumonia is associated with higher mortality. Chest 137: 552–557.PubMedCrossRefGoogle Scholar
  13. 13.
    Marrie TJ, Shariatzadeh MR (2007) Community-acquired pneumonia requiring admission to an intensive care unit: a descriptive study. Medicine (Baltimore) 86: 103–111CrossRefGoogle Scholar
  14. 14.
    Chalmers JD, Taylor JK, Mandal P, et al (2011) Validation of the Infectious Diseases Society Of America/American Thoracic Society minor criteria for intensive care unit admission in community-acquired pneumonia patients without major criteria or contraindications to intensive care unit care. Clin Infect Dis 53: 503–511PubMedCrossRefGoogle Scholar
  15. 15.
    Charles PG, Wolfe R, Whitby M, et al (2008) SMART-COP: a tool for predicting the need for intensive respiratory or vasopressor support in community-acquired pneumonia. Clin Infect Dis 47: 375–384PubMedCrossRefGoogle Scholar
  16. 16.
    Ewig S, Woodhead M, Torres A (2011) Towards a sensible comprehension of severe community-acquired pneumonia. Intensive Care Med 37: 214–223PubMedCrossRefGoogle Scholar
  17. 17.
    Mulrennan S, Tempone SS, Ling IT, et al (2010) Pandemic influenza (H1N1) 2009 pneumonia: CURB-65 score for predicting severity and nasopharyngeal sampling for diagnosis are unreliable. PLoS One 5: e12849PubMedCrossRefGoogle Scholar
  18. 18.
    Bloos F, Marshall JC, Dellinger RP, et al (2011) Multinational, observational study of procalcitonin in ICU patients with pneumonia requiring mechanical ventilation: a multicenter observational study. Crit Care 15: R88PubMedCrossRefGoogle Scholar
  19. 19.
    Barlow G, Nathwani D, Davey P (2007) The CURB65 pneumonia severity score outperforms generic sepsis and early warning scores in predicting mortality in community acquired pneumonia. Thorax 62: 253–259PubMedCrossRefGoogle Scholar
  20. 20.
    Mandell LA, Wunderink RG, Anzueto A, et al (2007) Infectious Diseases Society of America/ American Thoracic Society consensus guidelines on the management of community acquired pneumonia in adults. Clin Infect Dis 44 (Suppl 2): S27–S72PubMedCrossRefGoogle Scholar
  21. 21.
    Woodhead M, Blasi F, Ewig S, et al (2005) Guidelines for the management of adult lower respiratory tract infections. Eur Respir J 26: 1138–1180PubMedCrossRefGoogle Scholar
  22. 22.
    Martin-Loeches I, Lisboa T, Rodriguez A, et al (2010) Combination antibiotic therapy with macrolides improves survival in intubated patients with community-acquired pneumonia. Intensive Care Med 36: 612–620PubMedCrossRefGoogle Scholar
  23. 23.
    Martínez R, Reyes S, Lorenzo MJ, et al (2009) Impact of guidelines on outcome: the evidence. Semin Respir Crit Care Med 30: 172–178PubMedCrossRefGoogle Scholar
  24. 24.
    Menéndez R, Torres A, Reyes S, et al (2012) Initial management of pneumonia and sepsis. Factors associated with improved outcome. Eur Respir J 39: 156–162PubMedCrossRefGoogle Scholar
  25. 25.
    Vardakas KZ, Siempos II, Grammatikos A, et al (2008) Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials. CMAJ 179: 1269–1277PubMedGoogle Scholar
  26. 26.
    Dellinger RP, Levy MM, Carlet JM, et al (2008) Surviving Sepsis Campaign: international guidelines formanagement of severe sepsis and septic shock: 2008. Crit Care Med 36: 296–327PubMedCrossRefGoogle Scholar
  27. 27.
    Kumar A, Ellis P, Arabi Y, et al (2009) Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 136: 1237–1248PubMedCrossRefGoogle Scholar
  28. 28.
    Bruns AH, Oosterheert JJ, Hustinx WN, et al (2009) Time for first antibiotic dose is not predictive for the early clinical failure of moderate-severe community-acquired pneumonia. Eur J Clin Microbiol Infect Dis 28: 913–919PubMedCrossRefGoogle Scholar
  29. 29.
    Pines JM, Isserman JA, Hinfey PB (2009) The measurement of time to first antibiotic dose for pneumonia in the emergency department: a white paper and position statement prepared for the American Academy of Emergency Medicine. J Emerg Med 37: 335–340PubMedCrossRefGoogle Scholar
  30. 30.
    Aliberti S, Blasi F, Zanaboni AM, et al (2010) Duration of antibiotic therapy in hospitalised patients with community-acquired pneumonia. Eur Respir J 36: 128–134PubMedCrossRefGoogle Scholar
  31. 31.
    Schuetz P, Christ-Crain M, Thomann R, et al (2009) Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA 302: 1059–1066PubMedCrossRefGoogle Scholar
  32. 32.
    Bouadma L, Luyt CE, Tubach F, et al (2010) Use of procalcitonin to reduce patients’ exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial. Lancet 375: 463–474PubMedCrossRefGoogle Scholar
  33. 33.
    Ambrose PG (2008) Use of pharmacokinetics and pharmacodynamics in a failure analysis of community-acquired pneumonia: implications for future clinical trial study design. Clin Infect Dis 47 (Suppl 3): S225–S231PubMedCrossRefGoogle Scholar
  34. 34.
    Blot SI, Rodriguez A, Solé-Violán J, et al (2007) Effects of delayed oxygenation assessment on time to antibiotic delivery and mortality in patients with severe community-acquired pneumonia. Crit Care Med 35: 2509–2514PubMedCrossRefGoogle Scholar
  35. 35.
    Carron M, Freo U, Zorzi M, et al (2010) Predictors of failure of noninvasive ventilation in patients with severe community-acquired pneumonia. J Crit Care 25: 540.e9–14CrossRefGoogle Scholar
  36. 36.
    Gattinoni L, Carlesso E, Taccone P, et al (2010) Prone positioning improves survival in severe ARDS: a pathophysiologic review and individual patient meta-analysis. Minerva Anestesiol 76: 448–454PubMedGoogle Scholar
  37. 37.
    Chan MC, Hsu JY, Liu HH, et al (2007) Effects of prone position on inflammatory markers in patients with ARDS due to community-acquired pneumonia. J Formos Med Assoc 106: 708–716PubMedCrossRefGoogle Scholar
  38. 38.
    Guerin C, Gaillard S, Lemasson S, et al (2004) Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial. JAMA 292: 2379–2387PubMedCrossRefGoogle Scholar
  39. 39.
    Thomas PJ, Paratz JD (2007) Is there evidence to support the use of lateral positioning in intensive care? A systematic review. Anaesth Intensive Care 35: 239–255PubMedGoogle Scholar
  40. 40.
    Marquette CH, Wermert D, Wallet F, et al (1997) [Fibroscopic bronchoscopy in intensive care]. Rev Mal Respir 14: 101–111PubMedGoogle Scholar
  41. 41.
    Fartoukh M, Azoulay E, Galliot R, et al (2002) Clinically documented pleural effusions in medical ICU patients: how useful is routine thoracentesis? Chest 121: 178–184PubMedCrossRefGoogle Scholar
  42. 42.
    Tu CY, Hsu WH, Hsia TC, et al (2006) The changing pathogens of complicated parapneumonic effusions or empyemas in a medical intensive care unit. Intensive Care Med 32: 570–576PubMedCrossRefGoogle Scholar
  43. 43.
    The Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators (2009) Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA 302: 1888–1895CrossRefGoogle Scholar
  44. 44.
    Meduri GU, Rocco PR, Annane D, et al (2010) Prolonged glucocorticoid treatment and secondary prevention in acute respiratory distress syndrome. Expert Rev Respir Med 4: 201–210PubMedCrossRefGoogle Scholar
  45. 45.
    Snijders D, Daniels JM, de Graaff CS, et al (2010) Efficacy of corticosteroids in community-acquired pneumonia: a randomized double-blinded clinical trial. Am J Respir Crit Care Med 181: 975–982PubMedCrossRefGoogle Scholar
  46. 46.
    Meijvis SC, Hardeman H, Remmelts HH, et al (2011) Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial. Lancet 377: 2023–2030PubMedCrossRefGoogle Scholar
  47. 47.
    Black PN, Morgan-Day A, McMillan TE, et al (2004) Randomised, controlled trial of Nacetylcysteine for treatment of acute exacerbations of chronic obstructive pulmonary disease [ISRCTN21676344]. BMC Pulm Med 4: 13PubMedCrossRefGoogle Scholar
  48. 48.
    Chalmers JD, Singanayagam A, Murray MP, et al (2008) Prior statin use is associated with improved outcomes in community-acquired pneumonia. Am J Med 121: 1002–1007PubMedCrossRefGoogle Scholar
  49. 49.
    Yende S, Milbrandt EB, Kellum JA, et al (2011) Understanding the potential role of statins in pneumonia and sepsis. Crit Care Med 39: 1871–1878PubMedCrossRefGoogle Scholar
  50. 50.
    Pham JC, Kelen GD, Pronovost PJ (2007) National study on the quality of emergency department care in the treatment of acute myocardial infarction and pneumonia. Acad Emerg Med 14: 856–863PubMedCrossRefGoogle Scholar
  51. 51.
    Laterre PF, Garber G, Levy H, et al (2005) Severe community-acquired pneumonia as a cause of severe sepsis: data from the PROWESS study. Crit Care Med 33: 952–961PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • J. Vergragt
  • J. Kesecioglu
  • D. W. de Lange

There are no affiliations available

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