Smjernice za liječenje pneumonija iz opće populacije u odraslih

Professional paper - Professional paper

• Title (english): Guidelines for the management of community-acquired pneumonia in adults
• Author: Ilija Kuzman
• Author: Neven Rakušić
• Author: Rok Čivljak
• Author: Ivan Puljiz
• Author: Marko Kutleša
• Author: Antea Topić
• Author: Ivica Mažuranić
• Author: Anđelko Korušić
• Author: Zlata Ožvačić Adžić
• Author: Bruno Baršić
• Author: Miroslav Samaržija
• Author: Dragan Soldo
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Community-acquired pneumonia (CAP), or pneumonia acquired outside the hospital, is a very common disease caused by numerous microorganisms with various clinical presentations, disease severity and outcome. CAP is associated with significant morbidity and mortality in affected population and rising costs of medical treatment worldwide. Uniform and improved clinical approach and treatment of adult patients with CAP is advocated in many guidelines developed by various institutions and professional associations. All current guidelines for the treatment of CAP are based on clinical ­diagnosis of pneumonia confirmed by chest radiography and empirical choice of antibiotics. As other well-known guidelines (American, European, British), the Croatian guidelines are trying to rationalize clinical approach based on the assessment of disease severity, patient age, comorbidities, risk factors and epidemiological data. Depending on disease severity, diagnostic and therapeutic procedures are prescribed according to the site of care for CAP patients: outpatient setting, hospital wards or the intensive care unit. Antibiotic treatment of pneumonia should be initiated immediately, or within four hours after establishing the clinical diagnosis. Parenteral administration of antibiotics can be switched to oral usually 48 to 96 hours from the start of treatment, even in patients with severe clinical presentation of disease if all criteria are met. Vaccination against influenza and pneumococcal disease is recommended for all high-risk persons. Expert representatives of five professional societies of the Croatian Medical Association and Croatian Thoracic Society and the Reference Center for Diagnosis and Treatment of Infectious Diseases of the Croatian Ministry of Health participated in the preparation of these guidelines. They are designed for general practitioners and specialists from different medical disciplines who treat patients with pneumonia in outpatient or hospital setting.

Abstract (croatian)

Pneumonija iz opće populacije, odnosno stečena izvan bolnice vrlo je česta bolest uzrokovana brojnim mikro­organizmima s različitom kliničkom pojavnošću, težinom i prognozom te ima važan udio u pobolu i smrtnosti pučanstva s rastućim troškovima liječenja u cijelom svijetu. Izjednačavanje i poboljšanje liječenja odraslih bolesnika propisuju smjernice mnogih institucija i profesionalnih udruženja. Sve moderne smjernice za liječenje pneumonija iz opće populacije ­temelje se na kliničkoj dijagnozi pneumonije potvrđene rendgenskom slikom pluća i empirijskom izboru antibiotika. Poput ostalih najpoznatijih (američke, europske, britanske), naše smjernice s racionalnim pristupom baziraju se na procjeni težine bolesti, dobi bolesnika, popratnim kroničnim bolestima, rizičnim čimbenicima i epidemiološkim podatcima. Na osnovi težine bolesti propisuju dijagnostičke i terapijske postupke prema mjestu zbrinjavanja pneumonija: ambulantno, na bolničkom odjelu, odnosno u jedinicama za intenzivno liječenje. Liječenje pneumonija antibiotikom treba započeti odmah, odnosno u roku od četiri sata nakon postavljanja kliničke dijagnoze. Parenteralna primjena antibiotika može se zamijeniti peroralnom najčešće 48 – 96 sati od početka liječenja, čak i u bolesnika s težim oblikom bolesti ako su zadovoljeni krite­riji. Cijepljenje protiv influence i pneumokokne bolesti preporučuje se svim osobama s povišenim rizikom. U izradi smjernica sudjelovali su ekspertni predstavnici pet relevantnih društava HLZ-a i Hrvatskoga torakalnog društva te Referentnog centra za dijagnostiku i liječenje infektivnih bolesti Ministarstva zdravstva Republike Hrvatske. Namijenjene su liječnicima obiteljske medicine i specijalistima različitih struka koji liječe bolesnike s pneumonijom ambulantno ili u bolnici.

• Language: croatian
• Publication type: Professional paper - Professional paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Liječnički vjesnik
• Numbering: vol. 139, no. 7-8, pp. 177-191
• p-ISSN: 0024-3477
• URN:NBN: urn:nbn:hr:105:291480
• Publication: 2017-07
• Document URL: https://hrcak.srce.hr/189744
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 09:42:40