Ambulant erworbene Pneumonie

Was ist neu?

Pathogene Die Bedeutung von Atemwegsviren bei der CAP wird zunehmend beschrieben. Influenza und Rhinoviren stehen aktuell im Fokus, aber auch andere Atemwegsviren werden genannt.

Risikostratifizierung: Zusätzlich zu den etablierten Parametern stellt der Blutglukosespiegel bei Aufnahme einen zusätzlichen Risikofaktor dar.

Antibiotika Der Stellenwert der zusätzlichen Makrolid-Gabe im Rahmen einer Kombination mit einem Betalaktam-Antibiotikum wird zunehmend differenziert. Patienten mit Bakteriämie und/oder ausgeprägter Entzündungsreaktion profitieren besonders. Bei Patienten mit schwerer Pneumonie sollte immer eine Kombinationstherapie durchgeführt werden. Omadacycline und Solithromycin stellen neue interessante Antibiotika mit erweitertem Spektrum dar.

Abstract

Important new developments in the understanding of CAP encompass new insights into pathogens, risk stratification and antibiotic treatment. Respiratory viruses are increasingly described as relevant pathogens in CAP, such as influenza and rhinoviruses. Risk stratification is central in the management of CAP. In addition to the classical scores blood glucose levels add to the risk prediction. Risk adapted antibiotic treatment is increasingly refined and the use of macrolides in patients with bacteremia or marked inflammation is advocated. Recently developed new antibiotics add to the therapeutic options in CAP.

Schlüsselwörter

Pathogene - Atemwegsviren - Management - Antibiotika - Risikostratifizierung

Key words

pathogens - respiratory viruses - management - antibiotics - risk stratification

• Literatur

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