Pneumonia - Highlights

Highlights

Overview

• While the incidence of Pneumonia is declining, it remains a widespread and significant healthcare issue in the US, particularly among people who require long-term medical care. An aging population, antibiotic resistance and increasing healthcare costs make this a particularly challenging problem.
• Pneumonia symptoms vary among children, adults and the elderly.
• Distinguishing the symptoms for rapid diagnosis, beginning appropriate antibiotics early, and determining where care should be delivered (ICU, hospital or home) are key to positive outcomes.
• Tools may be used to determine the most appropriate level of care, such as the Pneumonia Severity Index (PSI), British Thoracic Society Rule (BSR), and the CURB-65.

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Prognosis

• In a review of research evidence, statin use was shown to improve the outcome in patients with bacterial pneumonia. While this has been debated as a “healthy user effect,” additional analyses on these largely retrospective studies refute this claim. Researchers, however, stress the need for additional controlled research.

Risks

• Elderly adults, particularly those in nursing homes, and those with other medical conditions are at increased risk for pneumonia. Pneumonia is the second leading type of infection in nursing homes.

Treatment

• In adults, antibiotic therapy differs depending on the severity of infection and site of care. In all cases, timely therapy is vital to positive outcomes.

Prevention

• Yearly flu shots are recommended, and particularly important in senior populations and high risk individuals. Annual flu shots have been shown to reduce hospitalizations. The U.S. Centers for Disease Control and Prevention (CDC) Advisory Council has recommended that all people ages 6 months and older, unless contraindicated, have a flu shot in the upcoming 2010 - 2011 flu season.
• The new pneumococcal conjugate vaccine series Prevnar 13 replaces the current Prevnar 7 and is recommended for all children ages 6 weeks to 5 years.
• The pneumococcal polysaccharide vaccine is recommended for those between the ages of 2 and 65 who are felt to be high risk individuals and those over 65 years. A second dose is recommended 5 years after the initial dose in people who received their first dose before 65, and other high risk individuals.

Review Date: 04/13/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).