Author/Editor     Drinovec, Jože
Title     Epidemiološki in družbeni pomen okužb na spodnjih dihalih
Translated title     Epidemiologic and social significance of lower respiratory tract infections
Type     članek
Source     Krka Med Farm
Vol. and No.     Letnik 24, št. 35
Publication year     2003
Volume     str. 8-14
Language     slo
Abstract     Lower respiratory tract in fections are most common among children during their first few years of life and the elderly of advanced age, and in both groups, these in fections have the most serious consequences. The weekly incidence rate of acute bronchitis in the developed world is 87 per 100,000 population. Eficacy of antibiotic treatment is low and such therapy is rational only in high-risk patients with abundant purulent discharge. Chronic bronchitis represents a considerable social burden and affects between 3 and 6% of population, more often males, and most commonly the elderly. The highest costs attributable to an acute exacerbation of chronic bronchitis result from hospitalizations and absence from work. The incidence o f community-acquired pneumonia is 10 to 12/1,000 popularion per year; it is three times more common in children and in the elderly above 75 years of age. Community-acquired pneumonia (CAP) is associated with substantial mortality: 4% in children below the age of 5 years, 11% in patients above 60 years of age, 17% in patients above 75 years of age and 25% among patients requiring hospitalization. Mortality rate is even higher in nursing home patients than in patients of the same age living in domestic setting. In USA, the indirect costs of treatment of community-acguired pneumonia amount to USD 8.4 billion annually. Costs incurred by loss of income due to absence from work equal - if not exceed - indirect costs of treatment. The cost of treatment of community-acquired pneumonia can be reduced by outpatient treatment, reduction of length of hospital stay to a minimum, a rapid switch from parenteral to oral antibiotic therapy in hospitalized patients, and by strict adherence to professional recommendations.
Summary     Okužbe na spodnjih dihalih so najpogostejše pri otrocih v prvih letih življenja in pri ljudeh v pozni starosti. Pri obeh skupinah so tudi posledice najhujše. V razvitem svetu zboli za akutnim bronhitisom 87/100.000 prebivalcev na teden. Antibiotično zdravljenje je malo učinkovito in je smiselno samo pri obilnem gnojnem izmečku pri ogroženih bolnikih. Kronični bronhitis pomeni znatno družbeno obremenitev in zajema med 3 in 6% prebivalstva, pogosteje moške, najpogosteje v starosti. Največji stroški zdravljenja akutne eksacerbacije kroničnega bronhitisa gredo na račun bolnišničnega zdravljenja in odsotnosti z dela. Za zunajbolnišnično pljučnico zboli 10 do 12/1000 prebivalcev na leto, trikrat pogosteje otroci in starejši od 75 let. Smrtnost zaradi zunajbolnišnične pljučnice (ZBP) je znatna: 4-odstotna do 5. leta, ll-odstotna po 60. letu, 17-odstotna po 75. letu in 25-odstotna pri bolnikih, ki jih je bilo treba bolnišnično zdraviti. Pogostejša je v domovih za ostarele kot pri enako starih, ki živijo v domačem okolju. Neposredni stroški zdravljenja zunajbolnišnične pljučnice znašajo v ZDA 8,4 milijarde dolarjev na leto. Stroški zaradi izpada dohodka zaradi odsotnosti z dela so vsaj enaki kot neposredni stroški zdravljenja. Stroške zdravljenja zunajbolnišnične pljučnice zmanjšujejo ambulantno zdravljenje, čim krajše bolnišnično zdravljenje, hiter prehod s parenteralnega na peroralni antibiotik pri bolnišnično zdravljenih bolnikih in dosledno upoštevanje strokovnih priporočil.
Descriptors     RESPIRATORY TRACT INFECTIONS
BRONCHITIS
PNEUMONIA
COMMUNITY-ACQUIRED INFECTIONS