Pulmonary Medicine                                                   ISSN 1930-6741



Author : Ramesh Kaul ,MD, FCCP

The modern concepts in Pneumonia.

Infected alveolar sacs with inflammation would qualify to be diagnosed as pneumonia. Historically 

What is so different in present pneumonia management ?

Coverage for atypical organisms is further emphasized, population is older and more emphasis on immuno-compromised state and drug resistance.

Improvement and on going battle with drug resistance will keep changing the guidelines.

Age  patients are older then last ten years of reviews and research.

Antibiotics induced mortality with c. difficile , allergic nephropathy and escalating costs have brought a new paradigm in pulmonary care.

Pre admission antibiotic therapy , antibiotic resistance, epidemics of viral, P.P.L.O. and atypical organisms on rise.

Immuno compromised  status, advanced cardiac disease, and poor nutritional status have made management different due to co-Morbidities.

How should we treat the modern malady?

Community-acquired pneumonia (CAP)  
  discussion of drug-resistant
Streptococcus pneumoniae
(DRSP); a proposed approach to patient stratification for the
purpose of predicting the likely etiologic pathogens of different
patient populations with CAP; a summary of available and recommended
diagnostic studies; suggestions on how to define the
need for hospitalization and admission to the intensive care unit
(ICU) for patients with CAP; guidelines for antibiotic therapy
of CAP, including principles of therapy and specific recommendations
for each patient category; an approach to the nonresponding
patient, as well as a discussion of when to switch to
oral therapy and when to discharge an admitted patient with
CAP who is responding to initial therapy; and recommendations
for the use of pneumococcal and influenza vaccines.


 Guidelines for the Management of Adults with
Community-acquired Pneumonia
Diagnosis, Assessment of Severity, Antimicrobial Therapy, and Prevention

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