Community-acquired pneumonia

Lancet. 2021 Sep 4;398(10303):906-919. doi: 10.1016/S0140-6736(21)00630-9.

Abstract

Community-acquired pneumonia is not usually considered a high-priority problem by the public, although it is responsible for substantial mortality, with a third of patients dying within 1 year after being discharged from hospital for pneumoniae. Although up to 18% of patients with community-acquired pneumonia who were hospitalised (admitted to hospital and treated there) have at least one risk factor for immunosuppression worldwide, strong evidence on community-acquired pneumonia management in this population is scarce. Several features of clinical management for community-acquired pneumonia should be addressed to reduce mortality, morbidity, and complications related to community-acquired pneumonia in patients who are immunocompetent and patients who are immunocompromised. These features include rapid diagnosis, microbiological investigation, prevention and management of complications (eg, respiratory failure, sepsis, and multiorgan failure), empirical antibiotic therapy in accordance with patient's risk factors and local microbiological epidemiology, individualised antibiotic therapy according to microbiological data, appropriate outcomes for therapeutic switch from parenteral to oral antibiotics, discharge planning, and long-term follow-up. This Seminar offers an updated view on community-acquired pneumonia in adults, with suggestions for clinical and translational research.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Community-Acquired Infections / diagnosis*
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / mortality*
  • Community-Acquired Infections / prevention & control
  • Humans
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / immunology
  • Pneumonia / mortality
  • Risk Factors
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Ultrasonography

Substances

  • Anti-Bacterial Agents
  • Influenza Vaccines