Treatment of Community-Acquired Pneumonia in Immunocompromised Adults: A Consensus Statement Regarding Initial Strategies.

Community-Acquired Infections / microbiology Consensus Humans Immunocompromised Host Patient Care Management / methods Pneumonia / microbiology
community-acquired pneumonia immunocompromised pneumonia

Journal

Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335

Informations de publication

Date de publication:
11 2020
Historique:
received: 13 12 2019
revised: 03 04 2020
accepted: 09 05 2020
pubmed: 21 6 2020
medline: 28 5 2021
entrez: 21 6 2020
Statut: ppublish

Résumé

Community-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients. There is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP. This consensus document was created by a multidisciplinary panel of 45 physicians with experience in the treatment of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus. The panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiologic workup, general principles of empirical therapy, and empirical therapy for specific pathogens. This document offers general suggestions for the initial treatment of the immunocompromised patient who arrives at the hospital with pneumonia.

Sections du résumé

BACKGROUND
Community-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients.
RESEARCH QUESTION
There is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP.
STUDY DESIGN AND METHODS
This consensus document was created by a multidisciplinary panel of 45 physicians with experience in the treatment of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus.
RESULTS
The panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiologic workup, general principles of empirical therapy, and empirical therapy for specific pathogens.
INTERPRETATION
This document offers general suggestions for the initial treatment of the immunocompromised patient who arrives at the hospital with pneumonia.

Identifiants

DOI: 10.1016/j.chest.2020.05.598 PMID: 32561442 PMC: PMC7297164
pubmed: 32561442
pii: S0012-3692(20)31681-0
doi: 10.1016/j.chest.2020.05.598
pmc: PMC7297164
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1896-1911

Subventions

Organisme : NIAID NIH HHS
ID : U19 AI135964
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

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Auteurs

Julio A Ramirez (JA)

Division of Infectious Diseases, University of Louisville, Louisville, KY. Electronic address: j.ramirez@louisville.edu.

Daniel M Musher (DM)

Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, TX.

Scott E Evans (SE)

Department of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.

Charles Dela Cruz (C)

Pulmonary, Critical Care and Sleep Medicine, Yale University, New Haven, CT.

Kristina A Crothers (KA)

Veterans Puget Sound Health Care System, University of Washington, Seattle WA.

Chadi A Hage (CA)

Thoracic Transplant Program, Indiana University, Indianapolis, IN.

Stefano Aliberti (S)

Department of Pathophysiology and Transplantation, University of Milan, and Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy.

Antonio Anzueto (A)

South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital, and University of Texas Health, San Antonio, TX.

Francisco Arancibia (F)

Pneumology Service, Instituto Nacional del Tórax and Clínica Santa María, Santiago de Chile, Chile.

Forest Arnold (F)

Division of Infectious Diseases, University of Louisville, Louisville, KY.

Elie Azoulay (E)

Medical ICU, Saint-Louis Teaching Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.

Francesco Blasi (F)

Department of Pathophysiology and Transplantation, University of Milan, and Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy.

Jose Bordon (J)

Section of Infectious Diseases, Providence Health Center, Washington, DC.

Steven Burdette (S)

Wright State University Boonshoft School of Medicine, Dayton, OH.

Bin Cao (B)

Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.

Rodrigo Cavallazzi (R)

Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY.

James Chalmers (J)

Scottish Centre for Respiratory Research, School of Medicine, Ninewells Hospital and Medical School, Dundee, UK.

Patrick Charles (P)

Department of Infectious Diseases, Austin Health and Department of Medicine, University of Melbourne, Australia.

Jean Chastre (J)

Service de Médecine Intensive-Réanimation, Hôpital La Pitié-Salpêtrière, Sorbonne Université, APHP, Paris, France.

Yann-Erick Claessens (YE)

Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Monaco.

Nathan Dean (N)

Intermountain Medical Center and the University of Utah, Salt Lake City, UT.

Xavier Duval (X)

UMR 1137, IAME, INSERM, and CIC 1425, Hôpital Bichat-Claude Bernard, APHP, Paris, France.

Muriel Fartoukh (M)

Service de Médecine Intensive Réanimation, Hôpital Tenon, APHP, and APHP, Sorbonne Université, Faculté de Médecine Sorbonne Université, Paris, France.

Charles Feldman (C)

Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Thomas File (T)

Infectious Disease Section, Northeast Ohio Medical University and Infectious Disease Division, Summa Health, Akron, OH.

Filipe Froes (F)

ICU, Chest Department, Hospital Pulido Valente-Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.

Stephen Furmanek (S)

Division of Infectious Diseases, University of Louisville, Louisville, KY.

Martin Gnoni (M)

Division of Infectious Diseases, University of Louisville, Louisville, KY.

Gustavo Lopardo (G)

Fundación del Centro de Estudios Infectológicos, Buenos Aires, Argentina.

Carlos Luna (C)

Pulmonary Diseases Division, Universidad de Buenos Aires, Buenos Aires, Argentina.

Takaya Maruyama (T)

Department of Respiratory Medicine, National Hospital Organization Mie National Hospital, Tsu, Japan.

Rosario Menendez (R)

Pneumology Department, La Fe University and Polytechnic Hospital, La Fe Health Research Institute, Valencia, Spain.

Mark Metersky (M)

Division of Pulmonary, Critical Care and Sleep Medicine and Center for Bronchiectasis Care, University of Connecticut Health, Farmington, CT.

Donna Mildvan (D)

Icahn School of Medicine at Mount Sinai, New York, NY.

Eric Mortensen (E)

Department of Medicine, University of Connecticut Health Center, Farmington, CT.

Michael S Niederman (MS)

Pulmonary and Critical Care, New York Presbyterian/Weill Cornell Medical Center and Weill Cornell Medical College, New York, NY.

Mathias Pletz (M)

Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany.

Jordi Rello (J)

Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, and Infections Area, Vall d'Hebron Institute of Research, Barcelona, Spain.

Marcos I Restrepo (MI)

South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital, and University of Texas Health, San Antonio, TX.

Yuichiro Shindo (Y)

Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Antoni Torres (A)

Servei de Pneumologia, Hospital Clinic, Universitat de Barcelona. Barcelona, CIBERES, Spain.

Grant Waterer (G)

School of Medicine, University of Western Australia, Perth, Australia.

Brandon Webb (B)

Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, UT and Division of Infectious Diseases and Geographic Medicine, Stanford Medicine, Palo Alto, CA.

Tobias Welte (T)

German Center for Lung Research, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH) Clinic of Pneumology, Hannover Medical School, Hannover, Germany.

Martin Witzenrath (M)

Division of Pulmonary Inflammation and Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Richard Wunderink (R)

Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, IL.

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Classifications MeSH

questionsmedicales.fr › Infection › Infections communautaires › Treatment of Community-Acquired Pneumonia in...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Pensée (activité mentale) › Prise de décision › Consensus › Treatment of Community-Acquired Pneumonia in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Treatment of Community-Acquired Pneumonia in...
questionsmedicales.fr › Phénomènes du système immunitaire › Sujet immunodéprimé › Treatment of Community-Acquired Pneumonia in...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Treatment of Community-Acquired Pneumonia in...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Treatment of Community-Acquired Pneumonia in...