New points of view in abroad guidelines for the management of CAP or HAP in adults / 中国实用内科杂志

ABSTRACT

Since 2005,guidelines for the management of adults with CAP or HAP were updated in United States,Europe and Japan,respectively.In these new CAP guidelines,severity-of-illness scores could be used to decide site of care.Routine diagnostic tests to identify an etiologic diagnosis were optional for outpatients with CAP.Empirical antibiotic therapy regimen,time to first antibiotic dose and duration of antibiotic therapy were all detailed explained.In new HAP guidelines,prevention was still emphasized.In order to prevent VAP,measures should be taken to reduce the risk of aspiration,including subglottic drainage and maintenance of stable optimal endotracheal tube cuff pressure.Cultures of lower respiratory secretions have diagnostic value for VAP.The diagnostic accuracy of blind sampling was similar to that of bronchoscopy-directed methods.Much more attention was paid on multidrug resistant bacteria infections.