Management of pneumonia in the nursing home.
Pneumonia is a major cause of morbidity and mortality among nursing home residents. The approach to managing these patients has lacked uniformity because of the paucity of clinical trials, complexity of underlying comorbid diseases, and heterogeneity of administrative structures. The decision to hospitalize nursing home patients with pneumonia varies among institutions depending on staffing level, availability of diagnostic testing, and laboratory support. In the absence of comparative studies, choice of empirical antibiotic therapy continues to be based on expert opinion. Validated prognostic scoring models are needed for risk stratification. Pneumococcal and influenza vaccination are the primary prevention measures. As of January 2010, Medicare no longer pays for consultation codes; thus, practitioners must instead use existing evaluation and management service codes when providing these services.
Division of Pulmonary, Critical Care, and Sleep Medicine, Veterans Affairs Western New York Healthcare System, Buffalo, NY 14215-1199, USA. solh@buffalo.edu
Ali A
AA
El-Solh
Mike S
MS
Niederman
Paul
P
Drinka
D000368:Aged; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D017408:Guidelines as Topic; D006707:Homes for the Aged; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007252:Influenza Vaccines / Q000008:administration & dosage; D008297:Male; D020380:Needs Assessment; D009735:Nursing Homes; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011014:Pneumonia / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000592:standards / Q000639:trends
D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines