Healthcare-associated pneumonia: principles and emerging concepts on management.
Healthcare-associated pneumonia (HCAP) is a relatively new entity that includes pneumonia occurring in healthcare settings other than acute-care hospitals. Many patients with HCAP are at greater risk for colonization and infection with multi-drug resistant (MDR) bacteria such as Pseudomonas aeruginosa, Gram-negative bacilli-producing extended-spectrum beta-lactamases and methicillin-resistant Staphylococcus aureus. Infections with these MDR pathogens require different empiric antibiotic therapy. To avoid initiation of inappropriate antibiotic therapy that may result in poorer patient outcomes, new principles for HCAP management were outlined in the 2005 American Thoracic Society and Infectious Diseases Society of America guidelines. These guidelines were suggested for patients assessed in acute-care hospitals and clinics, and may not be applicable for all patients with suspected HCAP in nursing homes and other long-term care settings. This review article addresses HCAP management strategies in both clinical settings.
Lahey Clinic Medical Center, Department of Pulmonary and Critical Care Medicine, Burlington, Massachusetts 01805, USA.
Alexandra
A
Chroneou
Nikolaos
N
Zias
John F
JF
Beamis
Donald E
DE
Craven
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D006760:Hospitalization; D006801:Humans; D009735:Nursing Homes; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control; D017410:Practice Guidelines as Topic
D000900:Anti-Bacterial Agents