Candent issues in pneumonia. Reflections from the Fifth Annual Meeting of Spanish Experts 2023.

C M Rodríguez-Leal, C González-Corralejo, F J Candel, M Salavert
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Abstract

Pneumonia is a multifaceted illness with a wide range of clinical manifestations, degree of severity and multiple potential causing microorganisms. Despite the intensive research of recent decades, community-acquired pneumonia remains the third-highest cause of mortality in developed countries and the first due to infections; and hospital-acquired pneumonia is the main cause of death from nosocomial infection in critically ill patients. Guidelines for management of this disease are available world wide, but there are questions which generate controversy, and the latest advances make it difficult to stay them up to date. A multidisciplinary approach can overcome these limitations and can also aid to improve clinical results. Spanish medical societies involved in diagnosis and treatment of pneumonia have made a collaborative effort to actualize and integrate last expertise about this infection. The aim of this paper is to reflect this knowledge, communicated in Fifth Pneumonia Day in Spain. It reviews the most important questions about this disorder, such as microbiological diagnosis, advances in antibiotic and sequential therapy, management of beta-lactam allergic patient, preventive measures, management of unusual or multi-resistant microorganisms and adjuvant or advanced therapies in Intensive Care Unit.

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肺炎的隐患。来自 2023 年第五届西班牙专家年会的思考。
肺炎是一种多发性疾病,其临床表现、严重程度和潜在致病微生物多种多样。尽管近几十年来对其进行了深入研究,但在发达国家,社区获得性肺炎仍是导致死亡的第三大原因,也是感染导致死亡的第一大原因;而医院获得性肺炎则是重症患者死于院内感染的主要原因。全世界都有治疗这种疾病的指南,但有些问题会引起争议,而且最新进展也使指南难以跟上时代的步伐。多学科方法可以克服这些局限性,也有助于改善临床效果。参与肺炎诊断和治疗的西班牙医学会已开展合作,努力实现和整合有关肺炎感染的最新专业知识。本文旨在反映在西班牙第五个肺炎日中传播的这些知识。它回顾了有关这一疾病的最重要问题,如微生物诊断、抗生素和序贯疗法的进展、β-内酰胺过敏患者的管理、预防措施、异常或多重耐药微生物的管理以及重症监护病房的辅助或先进疗法。
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