An Update on the Management Of Hospital-Acquired Pneumonia in the Elderly
Pneumonia is the leading cause of infection-related death and represents the fifth cause of mortality in the elderly. There are several reported risk factors for acquiring pneumonia at an older age, such as alcoholism, lung and heart diseases, nursing home residence, and swallowing disorders. Hospit...
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| Format: | Article |
| Language: | English |
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Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)
2008-12-01
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| Series: | International Journal of Gerontology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1873959809700079 |
| _version_ | 1831523139077537792 |
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| author | Chao-Hsien Lee Chien-Liang Wu |
| author_facet | Chao-Hsien Lee Chien-Liang Wu |
| author_sort | Chao-Hsien Lee |
| collection | DOAJ |
| description | Pneumonia is the leading cause of infection-related death and represents the fifth cause of mortality in the elderly. There are several reported risk factors for acquiring pneumonia at an older age, such as alcoholism, lung and heart diseases, nursing home residence, and swallowing disorders. Hospital-acquired pneumonia (HAP) is reviewed, with an emphasis on multidrug-resistant (MDR) bacterial pathogens, such as Pseudomonas aeruginosa, Acinetobacter species, and methicillin-resistant Staphylococcus aureus. The clinical characteristics of pneumonia in the elderly differ substantially compared with younger patients, and the severity of the disease is strongly associated with increased age and age-related comorbid disorders. Streptococcus pneumoniae is the pathogen most frequently responsible for pneumonia in the elderly with early HAP without risk factors for MDR; enteric Gram-negative rods should be considered in nursing home-associated pneumonia, as well as anaerobes in patients with aspiration pneumonia. Special attention should be given to preventive measures such as vaccination, oral care, and nutrition. The management of HAP should be instituted early with: appropriate use of antibiotics in adequate doses; avoidance of excessive use of antibiotics by de-escalation of initial antibiotic therapy, based on microbiologic cultures and the clinical response of the patient; and reduction of the duration of treatment to the minimum effective period. |
| first_indexed | 2024-12-14T11:38:20Z |
| format | Article |
| id | doaj.art-053b2e7056b24d5c9951e359f566b7fd |
| institution | Directory Open Access Journal |
| issn | 1873-9598 |
| language | English |
| last_indexed | 2024-12-14T11:38:20Z |
| publishDate | 2008-12-01 |
| publisher | Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM) |
| record_format | Article |
| series | International Journal of Gerontology |
| spelling | doaj.art-053b2e7056b24d5c9951e359f566b7fd2022-12-21T23:02:54ZengTaiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)International Journal of Gerontology1873-95982008-12-012418319510.1016/S1873-9598(09)70007-9An Update on the Management Of Hospital-Acquired Pneumonia in the ElderlyChao-Hsien Lee0Chien-Liang Wu1Division of Chest and Critical Care Medicine, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanDivision of Chest and Critical Care Medicine, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanPneumonia is the leading cause of infection-related death and represents the fifth cause of mortality in the elderly. There are several reported risk factors for acquiring pneumonia at an older age, such as alcoholism, lung and heart diseases, nursing home residence, and swallowing disorders. Hospital-acquired pneumonia (HAP) is reviewed, with an emphasis on multidrug-resistant (MDR) bacterial pathogens, such as Pseudomonas aeruginosa, Acinetobacter species, and methicillin-resistant Staphylococcus aureus. The clinical characteristics of pneumonia in the elderly differ substantially compared with younger patients, and the severity of the disease is strongly associated with increased age and age-related comorbid disorders. Streptococcus pneumoniae is the pathogen most frequently responsible for pneumonia in the elderly with early HAP without risk factors for MDR; enteric Gram-negative rods should be considered in nursing home-associated pneumonia, as well as anaerobes in patients with aspiration pneumonia. Special attention should be given to preventive measures such as vaccination, oral care, and nutrition. The management of HAP should be instituted early with: appropriate use of antibiotics in adequate doses; avoidance of excessive use of antibiotics by de-escalation of initial antibiotic therapy, based on microbiologic cultures and the clinical response of the patient; and reduction of the duration of treatment to the minimum effective period.http://www.sciencedirect.com/science/article/pii/S1873959809700079agedagingcross infectionpneumonia |
| spellingShingle | Chao-Hsien Lee Chien-Liang Wu An Update on the Management Of Hospital-Acquired Pneumonia in the Elderly International Journal of Gerontology aged aging cross infection pneumonia |
| title | An Update on the Management Of Hospital-Acquired Pneumonia in the Elderly |
| title_full | An Update on the Management Of Hospital-Acquired Pneumonia in the Elderly |
| title_fullStr | An Update on the Management Of Hospital-Acquired Pneumonia in the Elderly |
| title_full_unstemmed | An Update on the Management Of Hospital-Acquired Pneumonia in the Elderly |
| title_short | An Update on the Management Of Hospital-Acquired Pneumonia in the Elderly |
| title_sort | update on the management of hospital acquired pneumonia in the elderly |
| topic | aged aging cross infection pneumonia |
| url | http://www.sciencedirect.com/science/article/pii/S1873959809700079 |
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