Medicus, Vol. 14 No. 1_ARI, 2005.
Pregledni rad
Treatment of Pneumonias: How Important Are the Guidelines?
Ilija Kuzman
Sažetak
Despite continuous progress, diagnostics
and especially the treatment of pneumonias are accompanied
with numerous controversies. Algorithms provide summary
guidelines for numerous practical problems in diagnosis and
treatment of pneumonias. Numerous factors, which differ
to a signifi cant extent among certain countries, affect the
development and implementation of algorithms. In addition
to the choice of an antibiotic, modern algorithms for the
management of pneumonias defi ne diagnostic procedures,
criteria for hospitalisation and length of treatment, transfer
from parenteral to oral administration of antibiotics,
preventive measures, etc.
The most known algorithms (several American, Canadian,
British, that of the European Respiratory Society) are based
on empirical treatment of pneumonias. Nowadays it is
generally accepted that the antibiotic effi cient against
Streptococcus pneumoniae and atypical pathogens should be
administered in the initial empirical treatment. In outpatient
treatment, these algorithms recommend macrolides,
doxycycline or new (respiratory) fl uoroquinolones. In hospital
treatment, they recommend a beta-lactam antibiotic in
combination with a macrolide or a fl uoroquinolone antibiotic
effi cient against pneumococcus. The recommend algorithm
for the treatment of more severe pneumonias is the onset of
hospital treatment with parenteral antibiotic administration,
followed by oral administration once the patient’s status
stabilises (switch therapy).
Respecting numerous factors affecting the management
of pneumonias in Croatia and starting from the current
status, while including the already traditional clinical
classifi cation of pneumonias into bacterial and atypical,
national algorithms for effi cient and rational treatment of
pneumonias should be developed. This article suggests
various algorithms for treatment of pneumonias.
Ključne riječi
pneumonia; treatment; algorithms; betalactam antibiotics; macrolides; fl uoroquinolones
Hrčak ID:
18821
URI
Datum izdavanja:
26.1.2005.
Posjeta: 7.095 *