Abordaje de la neumonía adquirida en la comunidad en adultos - Sociedad Argentina de Infectología.
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| Title: | Abordaje de la neumonía adquirida en la comunidad en adultos - Sociedad Argentina de Infectología. |
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| Alternate Title: | Management of community-acquired pneumonia in adults. |
| Authors: | di Líbero, Eugenia1,2 (AUTHOR) eugeniadilibero@gmail.com, Duarte, Andrea3,4 (AUTHOR), Kaneshiro, Vanesa5 (AUTHOR), Gañete, Marcelo1,6 (AUTHOR), Aronson, Sandra3 (AUTHOR), López Furst, Maria José7 (AUTHOR) |
| Source: | Medicina (Buenos Aires). ene/feb2026, Vol. 86 Issue 1, p145-165. 21p. |
| Subjects: | COMMUNITY-acquired pneumonia, DIAGNOSIS, SEVERITY of illness index, CORTICOSTEROIDS, VIROLOGY, ANTIBACTERIAL agents, COVID-19, STREPTOCOCCUS pneumoniae |
| Abstract (English): | Community-acquired pneumonia (CAP) is respon sible for substantial morbidity and mortality worldwide. Epidemiological surveillance indicates that Streptococcus pneumoniae remains the most frequent etiological agent and the leading cause of mortality. However, with the advent of new diagnostic techniques, viral etiology has gained priority. Chest X-ray is considered mandatory to confirm the diagnosis and establish the spread. Mi crobiological, antigen, molecular, biomarker, and car riage tests have specific indications and a role to play in reconsidering empirical treatments. Severity scales are useful for defining the site of care, and the most validated prognostic models are PSI and CURB-65. When antibacterial treatment is appropriate, aminopenicillins ± beta-lactamase inhibitors are the preferred treatment, with the addition of a macrolide in severe cases. Pseu domonas and methicillin-resistant Staphylococcus aureus should be considered primarily in patients with a history of prior infection/colonization or severe structural lung disease. Shortened courses have gained support in the literature, and once clinical stability is achieved, it is suggested that treatment be continued for 3-5 days for CAP managed in an outpatient/general ward setting, and 5-7 days for CAP requiring intensive care. The role of cor ticosteroids in reducing mortality has been documented in severe forms. The benefit of neuraminidase inhibitors for influenza is of low certainty and relatively marginal. Treatments that have had an impact on reducing mor tality from severe-critical COVID-19 are corticosteroids, IL-6 receptor blockers, and baricitinib. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | La neumonía adquirida en la comunidad (NAC) es responsable de una importante morbimortalidad a ni vel global. De la vigilancia epidemiológica surge que el Streptococcus pneumoniae continúa siendo el agente etio lógico más frecuente y la primera causa de mortalidad. Sin embargo, con el advenimiento de nuevas técnicas diagnósticas cobró jerarquía la etiología viral. La radio grafía de tórax se considera mandatoria para confirmar el diagnóstico y establecer la extensión. Las pruebas mi crobiológicas, de antígenos, moleculares, biomarcadores y exámenes de portación tienen indicaciones precisas y un rol para reconsiderar los tratamientos empíricos. Las escalas de gravedad son de utilidad para definir el sitio de cuidado y las más validadas como modelos de pronóstico son PSI y CURB-65. Cuando corresponde tratamiento antibacteriano, son de elección las aminope nicilinas ± inhibidor de betalactamasas, con agregado de macrólido en las formas graves. Pseudomonas y Staphylo coccus aureus meticilino resistente deben considerarse fundamentalmente con el antecedente de infección/ colonización previa o enfermedad pulmonar estructural grave. Las pautas acortadas han obtenido sostén en la literatura y se sugiere, lograda la estabilidad clínica, 3-5 días en las NAC de manejo ambulatorio/sala general, y 5 a 7 días para las que requieren cuidados intensivos. El rol de los corticoides en la reducción de la mortalidad se ha establecido en las formas graves. El beneficio de los inhibidores de neuraminidasa para influenza es de poca certeza y relativamente marginal. Los tratamientos que han impactado en la disminución de la mortalidad por COVID-19 grave-crítico son los corticoides, los blo queadores del receptor de IL-6 y baricitinib. [ABSTRACT FROM AUTHOR] |
| Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
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| Abstract: | Community-acquired pneumonia (CAP) is respon sible for substantial morbidity and mortality worldwide. Epidemiological surveillance indicates that Streptococcus pneumoniae remains the most frequent etiological agent and the leading cause of mortality. However, with the advent of new diagnostic techniques, viral etiology has gained priority. Chest X-ray is considered mandatory to confirm the diagnosis and establish the spread. Mi crobiological, antigen, molecular, biomarker, and car riage tests have specific indications and a role to play in reconsidering empirical treatments. Severity scales are useful for defining the site of care, and the most validated prognostic models are PSI and CURB-65. When antibacterial treatment is appropriate, aminopenicillins ± beta-lactamase inhibitors are the preferred treatment, with the addition of a macrolide in severe cases. Pseu domonas and methicillin-resistant Staphylococcus aureus should be considered primarily in patients with a history of prior infection/colonization or severe structural lung disease. Shortened courses have gained support in the literature, and once clinical stability is achieved, it is suggested that treatment be continued for 3-5 days for CAP managed in an outpatient/general ward setting, and 5-7 days for CAP requiring intensive care. The role of cor ticosteroids in reducing mortality has been documented in severe forms. The benefit of neuraminidase inhibitors for influenza is of low certainty and relatively marginal. Treatments that have had an impact on reducing mor tality from severe-critical COVID-19 are corticosteroids, IL-6 receptor blockers, and baricitinib. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00257680 |
