Nationwide survey on the 2005 Guidelines for the Management of Community-Acquired Adult Pneumonia: Validation of differentiation between bacterial pneumonia and atypical pneumonia

被引：10

作者：

Watanabe, Akira ^{[1
]}

Goto, Hajime ^{[2
]}

Kohno, Shigeru ^{[3
]}

Matsushima, Toshiharu ^{[4
]}

Abe, Shosaku ^{[5
]}

Aoki, Nobuki ^{[6
]}

Shimokata, Kaoru ^{[7
]}

Mikasa, Keiichi ^{[8
]}

Niki, Yoshihito ^{[9
]}

机构：

[1] Tohoku Univ, Inst Dev Aging & Canc, Res Div Dev Antiinfect Agents, Aoba Ku, Seiryo Machi 4-1, Sendai, Miyagi 9808575, Japan

[2] Kyorin Univ, Sch Med, Dept Internal Med 1, Mitaka, Tokyo, Japan

[3] Nagasaki Univ, Dept Internal Med 2, Dept Mol Microbiol & Immunol, Grad Sch Biomed Sci, Nagasaki, Japan

[4] Kurashiki Daiichi Hosp, Resp Dis Ctr, Kurashiki, Okayama, Japan

[5] Sapporo Minami Sanjo Hosp, Dept Internal Med, Sapporo, Hokkaido, Japan

[6] Shinrakuen Hosp, Dept Internal Med, Niigata, Japan

[7] Chubu Univ, Dept Med Life Sci, Coll Life & Hlth Sci, Kasugai, Aichi, Japan

[8] Nara Med Univ, Ctr Infect Dis, Nara, Japan

[9] Showa Univ Hosp, Dept Clin Infect Dis, Tokyo, Japan

来源：

RESPIRATORY INVESTIGATION | 2012年 / 50卷 / 01期

关键词：

Guidelines for the management of community-acquired pneumonia; Differentiation of disease type; Antimicrobial treatment agent; Validation; Clinical effect;

D O I：

10.1016/j.resinv.2012.02.003

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Introduction: The Japanese Respiratory Society Guidelines for the Management of Community-Acquired Pneumonia (CAP) in Adults (JRS 2005) was published as a revision of the Basic Concept for the Management of CAP in Adults (JRS 2000). To evaluate the JRS 2005 criteria for differentiating between disease types and assessing the status of antimicrobial agent use in initial treatment, we conducted a prospective survey. Subjects and methods: The survey was conducted from July 2006 to March 2007 as a nationwide joint study by 200 institutions. The study subjects included patients aged ?16 years of age who had CAP, and patients who met the inclusion criteria were consecutively enrolled. Disease type differentiation based on JRS 2005 and JRS 2000 was conducted. Disease type diagnosis was also performed based on test results. The sensitivity and specificity of disease type differentiation were calculated. The antimicrobial agents used in the initial treatment were classified as recommended or non-recommended based on JRS 2005. The validity of non-recommended antimicrobial agent use was investigated. Results: A total of 1875 patients were analyzed. Differentiation of atypical pneumonia using the JRS 2005 criteria had higher sensitivity and lower specificity than differentiation using the JRS 2000 criteria. The antimicrobial agents recommended by JRS 2005 were used as initial treatment in a low number of cases. The efficacy of the recommended antimicrobial agents was similar to that of the non-recommended agents. Conclusions: JRS 2005 is advantageous in terms of reducing the number of items used in disease type differentiation. The recommended antimicrobial agents used for the initial treatment are believed to be appropriate. (C) 2012 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

引用

页码：23 / 32

页数：10

共 4 条

[1]

Committee for The Japanese Respiratory Society guidelines for the management of respiratory infections, 2006, Respirology, V11 Suppl 3, pS79

[2]

Community-acquired Pneumonia Medical Care Guideline- Drafting Committee of the Japanese Respiratory Society, 2000, GUID RESP INF BAS CO

[3]

The Committee for the Respiratory System Japan Society of Chemotherapy, 1997, JPN J CHEMOTHER, V45, P762

[4]

Watanabe Akira, 2003, Nihon Kokyuki Gakkai Zasshi, V41, P781

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