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Neumonia adquirida en la comunidad. Guia practica elaborada por un comite intersociedades / Neumonía acquired in the community. Practical guide elaborated by a committee intersocieties
Luna, Carlos M; Calmaggi, Anibal; Caberloto, Oscar; Gentile, Jorge; Valentini, Ricardo; Ciruzzi, Julian; Clara, Liliana; Rizzo, Oscar; Lasdica, Sergio; Blumenfeld, Marcelo; Benchetrit, Guillermo; Famiglietti, Angela; Apezteguia, Carlos; Monteverde, Alfredo.
  • Luna, Carlos M; s.af
  • Calmaggi, Anibal; s.af
  • Caberloto, Oscar; s.af
  • Gentile, Jorge; s.af
  • Valentini, Ricardo; s.af
  • Ciruzzi, Julian; s.af
  • Clara, Liliana; s.af
  • Rizzo, Oscar; s.af
  • Lasdica, Sergio; s.af
  • Blumenfeld, Marcelo; s.af
  • Benchetrit, Guillermo; s.af
  • Famiglietti, Angela; s.af
  • Apezteguia, Carlos; s.af
  • Monteverde, Alfredo; s.af
Medicina (B.Aires) ; 63(4): 319-343, 2003. tab
Artigo em Espanhol | LILACS | ID: lil-351378
ABSTRACT
Clinical practice guidelines for community-acquired pneumonia (CAP) contribute to improve patient's management. CAP undergoes continuous changes in etiology, epidemiology and antimicrobial sensitivity, requiring periodic guidelines revisions. An inter-society committee designed this guidelines dividing it into several topics based on prior guidelines and recent clinical studies. CAP compromises annually more than 1 of the population; most of the cases only require outpatient care but others are severe cases, reaching the 6th cause of death in Argentina. The cases are distributed unevenly into ambulatory, admitted in the general ward or in the intensive care unit. There is no way to predict the etiology. Unfavorable outcome predictors include age, antecedents and physical, laboratory and radiography findings. Ten to 25 of inpatients need to be admitted to the intensive care unit at the onset or during the follow-up, for mechanical ventilation or hemodynamic support (severe CAP). Severe CAP is associated with high mortality and requires adequate and urgent therapy. Pregnant, COPD and nursing home patients require special recommendations. Diagnosis is clinical, while complementary methods are useful to define etiology and severity; chest X-ray is the only one universally recommended. Other studies, including microbiologic evaluation are particularly appropriate in the hospitalized patients. The initial therapy is empiric, it must begin early, using antimicrobials active against the target microorganisms, avoiding their inappropriate use which can lead to the development of resistance. Length of therapy must not be unnecessarily prolonged. Hydratation, nutrition, oxygen and therapy of complications must complement antibiotic treatment. Prevention is based on influenza prophylaxis, anti-pneumococcal vaccine, aspiration prevention and other general

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Assuntos
Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Pneumonia / Infecções Comunitárias Adquiridas Tipo de estudo: Estudo de etiologia / Guia de Prática Clínica / Estudo prognóstico / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino / Gravidez Idioma: Espanhol Revista: Medicina (B.Aires) Assunto da revista: Medicina Ano de publicação: 2003 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Pneumonia / Infecções Comunitárias Adquiridas Tipo de estudo: Estudo de etiologia / Guia de Prática Clínica / Estudo prognóstico / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino / Gravidez Idioma: Espanhol Revista: Medicina (B.Aires) Assunto da revista: Medicina Ano de publicação: 2003 Tipo de documento: Artigo