Key concepts

There are five classifications of pneumonia: community acquired, aspiration, hospital acquired, ventilator associated, and health care associated.

The etiology of bacterial pneumonia varies in accordance with the type of pneumonia.

Streptococcus pneumoniae is the most common bacterial pathogen associated with community-acquired pneumonia (CAP).

The signs and symptoms and severity of pneumonia are needed not only to dia gnose the patient but also to determine and assess response to therapy. fi

The goal of therapy is to eliminate the patient's symptoms, minimize or prevent complications, and decrease mortality.

Treatment of CAP is predominantly empirical.

Empirical selection of antimicrobial therapy for ventilator-associated, health care-associated, and hospital-associated pneumonia is broad spectrum; however, once culture and susceptibility information are available the therapy should be narrowed (de-escalation) to cover the identified pathogen(s).

Duration of therapy should be kept to the shortest duration possible.

O Monitoring response to therapy is essential for determining efficacy, identifying adverse reactions, and determining the duration of therapy.

© Prevention of pneumococcal disease by use of vaccination is a national goal. Pneumonia is inflammation of the lung with consolidation. The cause of the inflammation is infection, which can be caused by a wide range of organisms. There are five classifications of pneumonia: community-acquired, aspiration, hospital-acquired, ventilator-associated, and health care-associated. Patients who develop pneumonia in the outpatient setting and have not been in any health care facilities including wound care and hemodialysis clinics have community-acquired pneumonia (CAP). Aspiration is of either oropharyngeal or GI contents. Hospital-acquired pneumonia (HAP) is

defined as pneumonia that occurs 48 hours or more after admission. ' Ventilator-associated pneumonia (VAP) requires endotracheal intubation for at least 48 to 72 hours

before the onset of pneumonia. The newest category is health care-associated pneumonia (HCAP), which is defined as pneumonia occurring in any patient hospitalized for at least 2 days within 90 days of the onset of the infection; residing in a nursing home or long-term care facility; received IV antibiotic therapy, wound care, or chemotherapy within the last 30 days of the onset of the infection; or having attended

a hemodialysis clinic. ' '

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