Sgs and culture as a reason to refuse these tests.

Infectious Diseases Society of America (IDSA), which has recently reviewed >> << etiology and presentation of CAP, proposed

new guidelines, which may lead to more effective care for the CAP

patients. Guide aims to streamline decision-making

to care and encourage continuing efforts to identify

infected organism. The aim is to rationalize antibiotic therapy >> << so as to maximize the chances of treatment and reduce the possibility

cause pathogen resistance. Diagrams of recommended treatment algorithm, adding stationary

management. Introduction to the algorithm begins with the patient >> << history according to CAP. This story could include such obvious

considerations, cough, fever, and previous hospitalizations for pneumonia >>. << MORE promote risk factors include viral CAP >> << infection, immune system disorders, neutropenia, pulmonary edema,

altered consciousness, airway obstruction, and congenital anomalies of lung >> . << First of all, IDSA principles strongly recommend chest radiographs

for all patients with suspected CAP, to confirm the presence of pneumonia >>. << Radiograph especially valuable for people hap

to the hospital because they provide a basic assessment

further progress or regress pneumonia. It is clear that patients with more risk factors for CAP may be higher

mortality risk. IDSA algorithm helps determine which patients benefit from

hospitalization. Clinical factors that are part of the solution >> << include respiratory failure, EDIS, mechanical interference

bilateral infiltrates or 50% increase in infiltrates, and >> << worsening chest radiograph within 48 hours of hospitalization. Additional indicators of severity of CAP include systolic and diastolic hypotension >> <<, deep sepsis with end organ dysfunction, and tachypnea

30 breaths / min. While these factors may be part of the patient

assessment, factors considered should not be this complex. Farr and others

others have studied the prognostic power provides 42

differences measurable clinical factors of CAP treatment outcome. They found that three parameters suggested physician better

to predict mortality of patients, including tachypnea

30 breaths / min, urea 19. 6 mg / dL, and diastolic blood pressure 60 mm Hg

. Diagnostic Evaluation of CAP patients are summarized in.

basic measurements including X-ray chest, sputum GramBЂ ™ s spot

(SGS), and possibly sputum for ordinary bacteria. Laboratory testing for stationary patients should include CBC with differential number >> << and chemistry panel including glucose, sodium serum

liver, kidney and electrolytes. The hospital, which

see more than one HIV-infected patient hospital discharges for 1000

serological testing for HIV should be run (with permission) for patients >> << aged 15 to 54 years. Seriously ill with no alternative diagnosis

or have suggestive findings should be tested for

mycobacterium tuberculosis and L Pneumophila. The main difference between the current ATS and IDSA guidelines is

greater emphasis on the IDSA to establish the etiology of each case >> << pneumonia. ATS believes the relatively low return on information

SGS and culture as a reason to refuse these tests. IDSA, however,

believes that these tests etiologic not only helps guide treatment in individual patients

, but also provide a significant sample >> << communityBЂ ™ with CAP models. Data from such tests can detect changes in the

source of infection and resistance in

pathogens in the community. This sample is not enough, however, quickly discover new

new or resurgent infectious organisms. BЂњEmerging infection

NetworkBЂ "on the website of the IDSA (http://www. Idsociety. Org)

provides a forum for disseminating information on the latest trends

recognized physicians who specialize in adults or children

Infectious Diseases. New infections

Network provides early warning system for the Centers for Disease Control and Prevention

and Prevention and other health care providers. General purposes of summary IDSA guidelines

management of microbiological laboratory for inpatient and outpatient therapy

For outpatients, SGS is desirable and Culture

conventional bacteria is optional. Hospitalized patients should >> << SGS and culture and sputum and blood. Recommendations for treatment of pathogen directed. Hospitalization

. on the basis of available prognostic criteria and antibiotic therapy

should start as early as possible. About 80% of patients treated hap outpatient.

IDSA principles call for pathogen-directed therapy for these individuals as well as

. Diagnostic strattera no prescritpion studies should include chest radiograph

and SGS. When the agent is unknown, empirical therapy should include >> << considerations disease severity, age patientBЂ ™ s,

, clinical signs, concomitant diseases, prior antibiotic therapy, and

Epidemiology. .