Abstract

Despite all advances in its management, community-acquired pneumonia (CAP) is still an important cause of morbidity and mortality requiring a great consumption of health, social, and economic resources. An early and adequate severity assessment is of paramount importance to provide optimized care to these patients. In the last 2 decades, this issue has been the subject of extensive research. Based on 30 day mortality, several prediction rules have been proposed to aid clinicians in deciding on the appropriate site of care. In spite of being well validated, their sensitivity and specificity vary, which limits their widespread use. The utility of biomarkers to overcome this problem has been investigated. At this moment, their full clinical value remains undetermined, and no single biomarker is consistently ideal for assessing CAP severity. Biomarkers should be seen as a complement rather than superseding clinical judgment or validated clinical scores. The search for a gold standard is not over, and new tools, like bacterial DNA load, are in the pipeline. Until then, CAP severity assessment should be based in three key points: a pneumonia-specific score, biomarkers, and clinical judgment.

Links

Publisher Full Text

Authors

Pereira JM, Paiva JA, Rello J

Institution

Emergency and Intensive Care Department, Centro Hospitalar S. João EPE, Faculdade de Medicina da Universidade do Porto, Porto, Portugal. jmcrpereira@yahoo.com

Source

Seminars in respiratory and critical care medicine 33:3 2012 Jun pg 272-83

MeSH

Bacterial Load
Biological Markers
Community-Acquired Infections
DNA, Bacterial
Decision Support Techniques
Humans
Pneumonia
Prognosis
Severity of Illness Index

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22718213