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Review
. 2021 Apr;34(2):72-80.
doi: 10.37201/req/114.2020. Epub 2020 Dec 9.

Community-acquired pneumonia: similarities and differences between European and American guidelines - A narrative review

J Barberán, R Restrepo, P Cardinal-Fernández  1
Affiliations
Review

Community-acquired pneumonia: similarities and differences between European and American guidelines - A narrative review

J Barberán et al. Rev Esp Quimioter. 2021 Apr.

Abstract
in English, Spanish

Community-acquired pneumonia (CAP) is severe disease. Early prescription of an adequate treatment has a positive impact in the CAP outcome. Despite the evidence of existing relevant differences between CAP across geographical areas, general guidelines can be designed to be applied everywhere. Eight years have passed between the publication of the European (EG) and American (AG) CAP guidelines, thus the aim of this narrative review is to compare both guidelines and summarize their recommendations. The main similarity between both guidelines is the antibiotics recommendation with the exception that AG mention new antimicrobials that were not available at the time of EG publication. Both guidelines recommend against routinely adding steroids as an adjuvant treatment. Finally, both guidelines acknowledge that the decision to hospitalize a patient is clinical and should be complemented with an objective tool for risk assessment. EG recommend the CRB-65 while AG recommend the Pneumonia Severity Index (PSI). EG and AG share a similar core of recommendations and only differ in minor issues such as new antibiotics. Likewise, both guidelines recommend against the routine prescription of steroids as an adjuvant therapy.

La neumonía adquirida en la comunidad (NAC) es una enfermedad grave. La prescripción temprana de un tratamiento adecuado ha demostrado mejorar el pronóstico de esta enfermedad. A pesar de que existen evidentes diferencias entre las NAC de acuerdo al área geográfica en la cual es diagnosticada, es posible realizar recomendaciones generales capaces de ser aplicadas en todo el mundo. Han pasado ocho años entre la publicación de las guías Euro-peas (GE) y Americanas (GA) de la NAC por lo cual el objetivo de la presente revisión narrativa es comparar ambas guías y resumir sus recomendaciones. La principal similitud entre ambas guías son las recomendaciones en los planes de antibióticos, con la diferencia que las GA mencionan a los nuevos antimicrobianos que no estaban disponible al momento de la publicación de GE. Ambas pautas recomiendan contra de la prescripción rutinaria de esteroides como tratamiento adyuvante. Finalmente, ambas guías reconocen que la decisión hospitalizar a un paciente es clínica, aunque debe complementarse con una herramienta objetiva para la evaluación de riesgos. Las GE recomiendan a la escala CRB-65 mientras que las GA al índice de severidad de la neumonía (PSI). En suma, ambas guías comparten la mayoría de las recomendaciones solo difiriendo en aspectos menores como los nuevos antibióticos. Ambas guías recomiendan en contra de la prescripción rutinaria de esteroides como terapia adyuvante.

Keywords: American guidelines; Community-Acquired Pneumonia; European guidelines; respiratory infections.

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Conflict of interest statement

The authors declare that they have no conflict of interest

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