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[Community-acquired pneumonia].

Der Internist 2009 March
Community-acquired pneumonia is the most common cause of death amongst all infectious diseases in the world. Mortality is low in patients treated as outpatients (<1%), but significantly raised (close to 14% in Germany) in hospital admitted patients. Especially at risk are patients from nursing homes, and patients with co-morbidities (chronic heart failure, chronic liver disease, neurological disease). Appropriate initial antibiotic therapy is the key factor in influencing patient outcome. Today, a risk stratification approach is used for initiating antibiotic therapy. Low risk patients can be treated as outpatients with a narrow spectrum beta-lactam for 5 days. With an increasing number of risk factors hospital admittance is recommended and broader spectrum antibiotics providing additional cover for atypical pathogens are required. Influenza and pneumococcal vaccination are proven to reduce the number and the severity of CAP cases significantly. The recommendations of the Ständige Impfkommission (Stiko) in Germany therefore warrant implementation in daily practice.

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