Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults
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ID: 289397
2007
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Abstract
priate starting point for consultation by specialists.Substantial overlap exists among the patients whom these guidelines address and those discussed in the recently published guidelines for health care-associated pneumonia (HCAP).Pneumonia in nonambulatory residents of nursing homes and other long-term care facilities epidemiologically mirrors hospital-acquired pneumonia and should be treated according to the HCAP guidelines.However, certain other patients whose conditions are included in the designation of HCAP are better served by management in accordance with CAP guidelines with concern for specific pathogens. Implementation of Guideline Recommendations1. Locally adapted guidelines should be implemented to improve process of care variables and relevant clinical outcomes.(Strong recommendation; level I evidence.)It is important to realize that guidelines cannot always account for individual variation among patients.They are not intended to supplant physician judgment with respect to particular patients or special clinical situations.The IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.Prevention (see table 13) 39.All persons у50 years of age, others at risk for influenza complications, household contacts of high-risk persons, and health care workers should receive inactivated influenza vaccine as recommended by the Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention.(Strong recommendation; level I evidence.)40.The intranasally administered live attenuated vaccine is an alternative vaccine formulation for some persons 5-49 years of age without chronic underlying diseases, including immunodeficiency, asthma, or chronic medical conditions.(Strong recommendation; level I evidence.)41.Health care workers in inpatient and outpatient settings and long-term care facilities should receive annual influenza immunization.(Strong recommendation; level I evidence.)42.Pneumococcal polysaccharide vaccine is recommended for persons у65 years of age and for those with selected high-risk concurrent diseases, according to current Advisory Committee on Immunization Practices guidelines.(Strong recommendation; level II evidence.)43.Vaccination status should be assessed at the time of hospital admission for all patients, especially those with medical illnesses.(Moderate recommendation; level III evidence.)44.Vaccination may be performed either at hospital discharge or during outpatient treatment.(Moderate recommendation; level III evidence.)45.Influenza vaccine should be offered to persons at hospital discharge or during outpatient treatment during the fall and winter.(Strong recommendation; level III evidence.)46.Smoking cessation should be a goal for persons hospitalized with CAP who smoke.(Moderate recommendation; level III evidence.)47.Smokers who will not quit should also be vaccinated for both pneumococcus and influenza.(Weak recommendation; level III evidence.)48.Cases of pneumonia that are of public health concern should be reported immediately to the state or local health department.(Strong recommendation; level III evidence.)49.Respiratory hygiene measures, including the use of hand hygiene and masks or tissues for patients with cough, should be used in outpatient settings and EDs as a means to reduce the spread of respiratory infections.(Strong recommendation; level III evidence.)
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| Authors | Lionel A. Mandell, Richard G. Wunderink, Antonio Anzueto, John G. Bartlett, G. Douglas Campbell, Nathan C. Dean, Scott F. Dowell, Thomas M. File, Daniel M. Musher, Michael S. Niederman, Antoní Torres, Cynthia G. Whitney |
| Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |
| Year | 2007 |
| DOI |
10.1086/511159
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| URL | |
| Keywords | Keywords not found |
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