title: Health care-associated pneumonia: an evidence-based review.
abstract: Health care-associated pneumonia is a relatively new classification of pneumonia that includes community-dwelling pneumonia patients having contact with the health care system. Current data indicate that health care-associated pneumonia patients present with more severe disease, are more likely to be infected with drug-resistant pathogens, and suffer increased mortality compared with community-acquired pneumonia patients. Guidelines recommend that these patients receive empiric antibiotics similar to those recommended for nosocomial pneumonia; however, it is not currently known if outcomes are improved when health care-associated pneumonia patients are treated with these therapies. In addition, the individual health care-associated pneumonia risk factors are based on limited data and are a poor predictor of patients likely to be infected with drug-resistant pathogens. Many questions remain on how to most appropriately care for this growing group of pneumonia patients. This review is an evidence-based discussion of current health care-associated pneumonia data, the individual health care-associated pneumonia risk factors, and limitations and additional considerations for the health care-associated pneumonia classification system.
authors.affiliation: Feik School of Pharmacy, University of the Incarnate Word, San Antonio, TX 78209-6397, USA. attridge@uiwtx.edu
authors.forename: Russell T
authors.initials: RT
authors.lastname: Attridge
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Frei
mesh_terms: D017714:Community-Acquired Infections / Q000453:epidemiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D003695:Delivery of Health Care; D024881:Drug Resistance, Bacterial; D019317:Evidence-Based Medicine; D006699:Home Care Services; D006707:Homes for the Aged; D006760:Hospitalization; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D009735:Nursing Homes; D010343:Patient Admission; D011014:Pneumonia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors