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Review
. 2016 Oct 1;20(1):267.
doi: 10.1186/s13054-016-1442-y.

New aspects in the management of pneumonia

Elena Prina  1 , Adrian Ceccato  1   2 , Antoni Torres  3   4   5
Affiliations
Review

New aspects in the management of pneumonia

Elena Prina et al. Crit Care. .

Abstract

Despite improvements in the management of community-acquired pneumonia (CAP), morbidity and mortality are still high, especially in patients with more severe disease. Early and appropriate antibiotics remain the cornerstone in the treatment of CAP. However, two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvant treatments, such as corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects. The use of corticosteroids in patients with severe CAP and a strong inflammatory reaction can reduce the time to clinical stability, the risk of treatment failure, and the risk of progression to acute respiratory distress syndrome. The administration of intravenous immunoglobulins seems to reinforce the immune response to the infection in particular in patients with inadequate levels of antibodies and when an enriched IgM preparation has been used; however, more studies are needed to determinate their impact on outcome and to define the population that will receive more benefit.

Keywords: Community-acquired pneumonia; Corticosteroid; Immunoglobulin.

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Figures

Fig. 1
Fig. 1
Flowchart for the management of patients with CAP
Fig. 2
Fig. 2
Potential harm and benefit of corticosteroids used in CAP
See this image and copyright information in PMC

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