COMMUNITY AQUIRED PNEUMONIA IN ADULTS: POSSIBILITIES OF TREATMENT IN OUTPATIENT CONDITIONS

Abstract

Community-acquired pneumonia (CAP) is a common and poorly diagnosed disease in the outpatient setting. The decision on hospitalization of the patient or treating him at home is the most important clinical conclusion made by the doctor in the course of the disease. Patients with non-severe course of CAP with the medical point of view are treated on an outpatient basis. Assessment of the severity of the patient CAP is based on the predictive Confusion-Respiratory rate – Blood pressure (CRB)-65 and criteria of systemic inflammatory response syndrome (SVR). CAP patients with a scale CRB 65 score 1 or more and/or syndrome SVR are hospitalized on an emergency basis. In accordance with the national guidelines for VAP amoxicillin is used to treat uncomplicated CAP as monotherapy (Group 1 included CAP patients). Amoxicillin is stable in an acidic environment and food intake doesn’t affect the drug absorption. Amoxicillin binds to plasma proteins by about 20% and easily permeates through histohematic barriers. The drug is active against aerobic gram-positive respiratory Staphylococcus spp. (except those strains producing penicillinase), Streptococcus pneumoniae and aerobic gram-negative respiratory organisms (Haemophilus influenzae, Escherichia coli, some strains of Klebsiella).