The Use of Drugs for The Elderly With Community-Acquired Pneumonia

2016 ◽  
Vol 38 (10) ◽  
pp. e27-e28 ◽  
Author(s):  
U Tilekeeva ◽  
A. Janbaeva
Keyword(s):  
The Elderly ◽  
Community Acquired Pneumonia

scholarly journals 10. Kinetics of Post-Vaccination Seroprotection to S. Pneumonia for the Immune-Compromised and Vaccine-Naïve Populations

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S27-S28
Author(s):  
Jeffrey Gruenglas ◽  
James Mond ◽  
Micaela Scobie ◽  
Cynthia Tolman ◽  
Joseph Martinez
Keyword(s):  
Capsular Polysaccharide ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Prior History ◽  
Antibody Activity ◽  
Vaccine Response ◽  
Serum Samples ◽  
Opsonic Activity ◽  
And Control

Abstract Background S. pneumonia infection presents a significant challenge, accounting for 20–38% of hospital-acquired pneumonia, and the leading cause of community-acquired pneumonia despite availability of effective vaccines. Incidence is highest in children under 2 years, the immunocompromised, and elderly. CDC has reported the emergence of antibiotic resistance in ~30% of cases, adding to risk of morbidity and mortality. Fewer than half of the elderly are vaccinated and vulnerable to infection on admission. Passive immunotherapy as an adjunct to vaccines may improve outcomes in such populations. The objective of this study was to evaluate whether seroprotective response induced with a pneumococcal conjugate vaccine could rapidly yield protective opsonic levels of antibody within anticipated duration of hospitalization. Methods Healthy donors (n=30) were immunized with Prevnar. Blood was drawn on days 0, 3, 7, 10, 14, 21, and 28. Samples were pooled and tested for presence of functional opsonic antibodies recognizing capsular polysaccharides. Clearance mechanism of S. pneumonia was based on antibody recognition to pneumococcal capsular polysaccharide and opsonic titers used as an in vitro surrogate to evaluate the efficacy of vaccine. Results There was little to no opsonic activity against most serotypes on day 0, except for low antibody activity with serotypes 1, 3, 4, and 5. Titers increased, with protective levels achieved by day 10 for most serotypes (except 14 and 18C), peaking at day 14 or after across serotypes (Figures 1 and 2). Average titers rose from log2 titer 2 on day 0 to log2 titer 8 on days 21 and 28. Titers against most serotypes reached log2 10 (titer 1024) or higher. Patients remained susceptible to nosocomial infection for at least 10 days post admission until protective titers are reached. OPK titers (log2 scale) for serum samples on day 0 (pre), day 3, 7, 10, 14, 21, 28, and control for S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V. N=2. OPK titers (log2 scale) for serum samples on day 0 (pre), day 3, 7, 10, 14, 21, 28, and control for S. pneumoniae serotypes 14, 18C, 19A, 19F, and 23F. N=2. Conclusion Patients with no prior history of vaccination (or inability to mount response) with Prevnar or pneumovax remain vulnerable to S. pneumonia infection even if vaccinated on entry, due to delayed kinetics in reaching protective titers. These patients may require prophylactic intervention of hyperimmune Ig with high opsonic titers to S. pneumonia, providing protection until vaccine response elicits protective antibodies. Disclosures All Authors: No reported disclosures

scholarly journals GP management of community-acquired pneumonia in Italy: the ISOCAP study

2005 ◽  
Vol 63 (1) ◽  
Author(s):  
C.M. Sanguinetti ◽  
F. De Benedetto ◽  
C.F. Donner
Keyword(s):  
Outpatient Treatment ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Microbiological Analysis ◽  
X Ray ◽  
Systemic Arterial Hypertension ◽  
Chest X Ray ◽  
Socioeconomic Burden ◽  
Copd Diagnosis ◽  
Observation Period

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.

scholarly journals Community-Acquired Pneumonia Recovery in the Elderly (CAPRIE): Efficacy and Safety of Moxifloxacin Therapy versus That of Levofloxacin Therapy

2006 ◽  
Vol 42 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Antonio Anzueto ◽  
Michael S. Niederman ◽  
James Pearle ◽  
Marcos I. Restrepo ◽  
Albrecht Heyder ◽  
...  
Keyword(s):  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Efficacy And Safety

Community-acquired pneumonia in the elderly

2009 ◽  
pp. 111-132 ◽  
Author(s):  
V. Kaplan ◽  
S. Yende ◽  
D.C. Angus
Keyword(s):  
The Elderly ◽  
Community Acquired Pneumonia

scholarly journals Clinical and laboratory findings in elderly with Community-Acquired Pneumonia in Babol, northern Iran – 2017-2019

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Saleh Habibi ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Parisa Sabbagh ◽  
Mehran Shokri
Keyword(s):  
Older Adults ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Vital Signs ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Northern Iran ◽  
Laboratory Findings ◽  
Cross Sectional

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

Community-acquired pneumonia in the elderly: A multivariate analysis of risk and prognostic factors.

1996 ◽  
Vol 154 (5) ◽  
pp. 1450-1455 ◽  
Author(s):  
R Riquelme ◽  
A Torres ◽  
M El-Ebiary ◽  
J P de la Bellacasa ◽  
R Estruch ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
The Elderly ◽  
Community Acquired Pneumonia

Community-Acquired Pneumonia Among the Elderly: Differences Between Patients Living at Home and in Nursing Homes

2004 ◽  
Vol 40 (12) ◽  
pp. 547-552 ◽  
Author(s):  
E. Martínez-Moragón ◽  
L. García Ferrer ◽  
B. Serra Sanchos ◽  
E. Fernández Fabrellas ◽  
A. Gómez Belda ◽  
...  
Keyword(s):  
Nursing Homes ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
At Home

scholarly journals Management of community-acquired pneumonia: essential tips for the physician on call

2020 ◽  
Vol 81 (5) ◽  
pp. 1-9 ◽  
Author(s):  
Malcolm Avari ◽  
Jeremy S Brown
Keyword(s):  
Clinical Problem ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Care Bundle ◽  
Clinical Markers ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Acute Hospitals ◽  
History Of ◽  
Short Courses

Community-acquired pneumonia is a common clinical problem requiring admission to hospital, with a particularly high incidence in the elderly population and those with significant comorbidities. Diagnosis is made on the combination of a short history of respiratory symptoms and systemic ill-health with new examination and/or radiological features of consolidation. Multiple other infective and non-infective conditions can mimic community-acquired pneumonia, leading to misdiagnosis in 5–17% of cases. The CURB-65 score can identify patients with community-acquired pneumonia with a higher risk of mortality, but is insensitive at identifying patients requiring intensive care support and needs to be combined with clinical markers of potential severity. Both high admission levels of C-reactive protein and the failure of levels of C-reactive protein to decline by >50% by day 4 after admission are associated with higher risk of complications, need for ventilation or inotropic support, and mortality. Empirical antibiotic therapy for most patients admitted to hospital is combination of a ß-lactam and a macrolide. Short courses of antibiotics do not result in significantly different outcomes to longer courses unless the patient has developed complications such as a complex parapneumonic effusion. Implementation of a community-acquired pneumonia care bundle into clinical practice reduces mortality, and should be a high priority for all acute hospitals.

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