Clinical perspectives in the management of pneumonia
aDepartment of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
bCentral Diagnostics Laboratory, Nagasaki University Hospital
Pneumonia is the third leading cause of overall death in Japan. Severe pneumonia is found to have a need for aggressive intensive care unit (ICU) management because of shock, organ dysfunction, or need for mechanical ventilation. The recent randomized controlled trials revealed that a combination antibiotic therapy with macrolides improves survival in patients with severe pneumonia. A switch from intravenous to oral antibiotic therapy is recommended for treating hospitalized patients with community-acquired pneumonia (CAP). We previously conducted a prospective randomized controlled study in hospitalized patients to evaluate the efficacy of switching therapy for CAP and to verify the selection criteria for patients receiving this therapy. Results indicated that switching therapy from injection to oral medication was cost-effective in treating community-acquired pneumonia. Rapid molecular diagnosis can enhance and improve the management of CAP. Loop-mediated isothermal amplification (LAMP) is one of the promising methods of gene amplification for detecting of respiratory pathogens.
Severe pneumonia Macrolide Switching therapy Molecular diagnosis
AJRS, 2(6): 708-716, 2013