Author/Editor		Vodopivec-Jamšek, Vlasta; Beović, Bojana
Title		Obravnava pljučnic, ki ne potrebujejo bolnišničnega zdravljenja
Translated title		Management of community-acquired pneumonia in primary care
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 45, št. Suppl 1
Publication year		2006
Volume		str. 418
Language		slo
Abstract		The annual incidence of community-acquired pneumonia diagnosed in the community is 5 to 11 per 1000 adult population. Most patients are treated as outpatients. Medical history and examination should be followed by chest radiograph if possible. Chest radiograph is especially recommended in patients with severe disease or unresponsiveness to previous treatment. The most common causative agents of community-acquired pneumonia in outpatients are Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydiophila pneumoniae, and in some circumstances Haemophilus influenzae, Moraxella catarrhalis and Legionella pneumophila. The approach to treatment is based on the patient's age and clinical presentation. The CRB system is a useful tool for evaluating the patient's condition. Beta-lactam antibiotics should remain the antibiotics of initial choice in adults with community-acquired pneumonia. The choice of antibiotic is also based on the patient's underlying diseases, which may lead to a more severe course of the disease and may be related to infection with a wider spectrum of more resistant pathogens. Prevention strategies include influenza and pneumococcal vaccination.
Summary		Pojavnost zunajbolnišnične pljučnice v razvitem svetu je med 5 in 11 na 1000 odraslih letno, večino bolnikov zdravimo ambulantno. Anamnezi in pregledu v ambulanti naj po možnosti, še zlasti pri hujših primerih in neuspehu zdravljenja, sledi rentgensko slikanje pljuč. Najpogostejši povzročitelji zunajbolnišnične pljučnice, ki jo zdravimo ambulantno, so Streptococcus pneumoniae, Mycoplasma pneumoniae in Chlamydiophila pneumoniae, v nekaterih okoliščinah tudi Haemophilus influenzae, Moraxella catarrhalis in Legionella pneumophila. Pri zdravljenju a upoštevamo bolnikovo stanje in starost. Ocenjujemo s pomočjo točkovalnika CRB. Betalaktamski antibiotiki so zdravila prvega izbora pri odraslih z izvenbolnišnično pljučnico. Pri izbiri antibiotika upoštevamo tudi bolnikove sočasne bolezni, ki predstavljajo nevarnost za hujši potek in okužbo s širšim spektrom odpornejših povzročiteljev. Poleg antibiotičnega zdravljenja potrebujejo bolniki tudi pravilno prehrano, hidracijo, antipiretike, zdravila proti bolečinam ter ustrezno zdravljenje osnovnih bolezni. Ukrepi preprečevanja bolezni vključujejo cepljenje proti gripi in okužbi s pnevmokoki.
Descriptors		PNEUMONIA, BACTERIAL COMMUNITY-ACQUIRED INFECTIONS FAMILY PRACTICE