Practical guidelines for the patient management with non-severe community-acquired pneumonia

A.A. Zaitsev¹, A.I. Sinopalnikov²

¹Main Military Clinical Hospital named after N.N. Burdenko, Moscow

²Russian Medical Academy of Continuous Professional Education, Moscow

Community-acquired pneumonia (CAP) is one of the most urgent problems of modern medicine due to its high incidence and mortality. The article discusses the role of various pathogens — bacteria and viruses, including COVID-19 — in the development of CAP. The authors consider the issues of CAP diagnosis, discuss the role of prognostic scales and biomarkers of inflammation, such as C-reactive protein and procalcitonin. Approaches to treatment of patients with CAP are described in detail. When planning the tactics of antimicrobial CAP chemotherapy, the doctor should take into account the clinical and epidemiological situation, the regional situation concerning antibiotic resistance, the presence of risk factors and patient compliance, as well as evaluate the drug safety in a specific clinical event. The article presents algorithms for drug selection to conduct empirical antimicrobial therapy of non-severe CAP on outpatient and inpatient basis. The authors consider in detail the criteria for the antimicrobial chemotherapy efficacy, which will allow the practitioner to adjust the patient management tactics in a timely manner, if necessary, and at the same time to avoid unjustified changes in the treatment regimen (after 24 hours from the beginning), not accompanied by positive effects, but leading only to the formation of antibiotic-resistant strains and of adverse events.

Keywords: community-acquired pneumonia, COVID-19, acute respiratory failure, acute respiratory distress syndrome, antimicrobial therapy, clinical guidelines, amoxicillin , clavulanate.

For citation: Zaitsev A.A., Sinopalnikov A.I. Practical guidelines for the patient management with non-severe community-acquired pneumonia. RMJ. 2020;4:19–23.