The Latest Management Of Community Acquired Pneumonia

The purpose of this literature review is to assess and appraise research studies in the last five years, investigating the latest management of community acquired pneumonia in immunocompromised adults patients. A literature search was performed using CINAHL Plus, Google Scholar, MEDLINE, EBSCOhost, UpToDate and PubMed databases. Boolean terms included: community acquired pneumonia, pneumonia, immunocompromised, adults, management, treatments, preventions, effectiveness, antibiotics, promotion, and outcomes. For each database, advance search was used and then limitations included systematic reviews, retrospective analysis, randomized control trial studies that were published, peer reviewed, full text, year of publication between 2010-2015, and English language, were applied.

Over the years, there has been an increase in diagnosis of immunosuppressive disease in the elderly in the community. Almost one third of hospital diagnosis in patients older than 6 years of age or older is community-acquired pneumonia and it is considered the sixth leading cause of death in developed countries according to Sousa, Justo, Dominguex, Manzur, Izquierdo, et al., 2012. In a prospective, observational study done in five public hospitals, where patients were diagnosed with CAP after seen in the emergency room three hundred and twenty cases were studied. Of those cases one hundred and fifteen occurred in immunocompromised patients. At all five hospitals, all patients had basic laboratory work completed such as basic metabolic panel, complete blood count, arterial blood gas, and a chest x-ray. However, after the initial laboratory tests, the administration of empirical antibiotics therapy based according to each hospital guidelines and poli...

... middle of paper ...

...of initial dual antibiotic therapy compared with single antibiotic therapy on mortality. Both groups of treatment received the first dose of antibiotic therapy within eight hours of admission. In the single antibiotic therapy group, patient received cefuroxime and for the dual antibiotic therapy group patients either received a Beta-lactam such as ceftriaxone or cefuroxime and macrolide. In the single antibiotic group 21% of the participants were considered immunocompromised whereas 17% of the participants were considered immunocompromised in the dual antibiotic group. The researchers were able to conclude that the single antibiotic therapy group had increase in mortality than the dual therapy group. It was concluded that initial empiric dual therapy with Beta lactam antibiotic and a macrolide decreases mortality in immunocompromised patients diagnosed with CAP.