Community-acquired bacterial pneumonia in adults: An update

Vandana Kalwaje Eshwara, Chiranjay Mukhopadhyay, Jordi Rello, Vandana Kalwaje Eshwara, Chiranjay Mukhopadhyay, Jordi Rello

Abstract

Community-acquired pneumonia (CAP) is the prominent cause of mortality and morbidity with important clinical impact across the globe. India accounts for 23 per cent of global pneumonia burden with case fatality rates between 14 and 30 per cent, and Streptococcus pneumoniae is considered a major bacterial aetiology. Emerging pathogens like Burkholderia pseudomallei is increasingly recognized as an important cause of CAP in Southeast Asian countries. Initial management in the primary care depends on clinical assessment while the hospitalized patients require combinations of clinical scores, chest radiography and various microbiological and biomarker assays. This comprehensive diagnostic approach together with additional sampling and molecular tests in selected high-risk patients should be practiced. Inappropriate therapy in CAP in hospitalized patients lengthens hospital stay and increases cost and mortality. In addition, emergence of multidrug-resistant organisms poses tough challenges in deciding empirical as well as definitive therapy. Developing local evidence on the cause and management should be a priority to improve health outcomes in CAP.

Keywords: Antimicrobial resistance; CABP; Streptococcus pneumoniae; bacteria; community acquired pneumonia; diagnosis; management.

Conflict of interest statement

None

Figures

Fig. 1
Fig. 1
Summary of guidelines on the management of acute cough at primary care. CRP, C-reactive protein; CR, chest radiograph; PCT, procalcitonin. Source : Refs .
Fig. 2
Fig. 2
Microbiological tests that may be adapted for comprehensive sampling strategy in community acquired pneumonia-based on disease severity and underlying risk in hospitalized patients. ICU, intensive care unit; PCR, polymerase chain reaction. Source : Refs .

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