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The aetiology and antibiotic management of community-acquired pneumonia in adults in Europe: a literature review
Ist Teil von
European journal of clinical microbiology & infectious diseases, 2014-07, Vol.33 (7), p.1065-1079
Ort / Verlag
Berlin/Heidelberg: Springer Berlin Heidelberg
Erscheinungsjahr
2014
Quelle
MEDLINE
Beschreibungen/Notizen
The purpose of this paper was to generate up-to-date information on the aetiology of community-acquired pneumonia (CAP) and its antibiotic management in adults across Europe. Structured searches of PubMed identified information on the aetiology of CAP and its antibiotic management in individuals aged >15 years across Europe. We summarise the data from 33 studies published between January 2005 and July 2012 that reported on the pathogens identified in patients with CAP and antibiotic treatment in patients with CAP.
Streptococcus pneumoniae
was the most commonly isolated pathogen in patients with CAP and was identified in 12.0–85.0 % of patients. Other frequently identified pathogens found to cause CAP were
Haemophilus influenzae
, Gram-negative enteric bacilli, respiratory viruses and
Mycoplasma pneumoniae
. We found several age-related trends:
S. pneumoniae
,
H. influenzae
and respiratory viruses were more frequent in elderly patients aged ≥65 years, whereas
M. pneumoniae
was more frequent in those aged <65 years. Antibiotic monotherapy was more frequent than combination therapy, and beta-lactams were the most commonly prescribed antibiotics. Hospitalised patients were more likely than outpatients to receive combination antibiotic therapy. Limited data on antibiotic resistance were available in the studies. Penicillin resistance of
S. pneumoniae
was reported in 8.4–20.7 % of isolates and erythromycin resistance was reported in 14.7–17.1 % of isolates. Understanding the aetiology of CAP and the changing pattern of antibiotic resistance in Europe, together with an increased awareness of the risk factors for CAP, will help clinicians to identify those patients most at risk of developing CAP and provide guidance on the most appropriate treatment.