Handläggning av samhällsförvärvad pneumoni hos vuxna. Evidensbaserade riktlinjer från Svenska infektionsläkarföreningen
Sammanfattning
This document presents the Swedish guidelines for the management of adult patients with community-acquired pneumonia (CAP), who are assessed at hospital. The prognostic score CRB-65 is recommended for all CAP patients in the emergency room. The score can aid the physician in decisions regarding treatment in hospital or outpatient treatment, level of hospital supervision, and empirical antibiotic treatment. Patients with CRB-65 0-1 can often be treated at home. Penicillin V is the primary antibiotic choice for this group. Patients with CRB-65 2 should regularly be hospitalised and the primary antibiotic choice is penicillin G. In cases with CRB-65 3-4, intensive care treatment should be considered. These patients should be treated with intravenous antibiotics, i.e. penicillin G + fluoroquinolone or cephalosporin + macrolide. Routine testing for microbiological aetiology is recommended to get support for the ongoing antibiotic therapy or to guide treatment alterations. Recommended measures for prevention of CAP include influenza vaccination and pneumococcal vaccination to risk groups and efforts for smoking cessation.