BACKGROUND: All the community acquired pneumonia followed up in an outpatient clinic were prospectively studied in order to determine: etiology, clinical-radiological characteristics and its progression with diagnostic and therapeutic protocols. PATIENTS AND METHOD: We arranged clinical evaluation protocols, etiological diagnosis by means of serology (in the first visit and three weeks later); and when necessary, by means of fiberbronchoscopy (protected microbiological brush), as well as clinical and radiological progression (up to three visits) after empirical treatment. RESULTS: Initially, 240 patients were included, of which 221 were fully followed up. Etiological diagnosis was obtained in 86 patients (39%). The bacteria most frequently isolated was Coxiella burnetii (12.2%), followed up Mycoplasma pneumoniae and Legionella pneumophila. Two cases of Strepcococus pneumoniae were diagnosed. The most frequent radiological onset was alveolar infiltrate (86%). The initial empiric treatment were macrolids (71%) or second generation cephalosporines (22%). Most patients presented a favourable clinical and radiological progression. Only 2 patients needed admission to the hospital (< 1%). CONCLUSIONS: In community acquired pneumonias studied in our outpatient clinic we found a high number of "atypical" agents. Treatment with macrolids or second generation cephalosporines are appropriate for these patients.
BACKGROUND: All the community acquired pneumonia followed up in an outpatient clinic were prospectively studied in order to determine: etiology, clinical-radiological characteristics and its progression with diagnostic and therapeutic protocols. PATIENTS AND METHOD: We arranged clinical evaluation protocols, etiological diagnosis by means of serology (in the first visit and three weeks later); and when necessary, by means of fiberbronchoscopy (protected microbiological brush), as well as clinical and radiological progression (up to three visits) after empirical treatment. RESULTS: Initially, 240 patients were included, of which 221 were fully followed up. Etiological diagnosis was obtained in 86 patients (39%). The bacteria most frequently isolated was Coxiella burnetii (12.2%), followed up Mycoplasma pneumoniae and Legionella pneumophila. Two cases of Strepcococus pneumoniae were diagnosed. The most frequent radiological onset was alveolar infiltrate (86%). The initial empiric treatment were macrolids (71%) or second generation cephalosporines (22%). Most patients presented a favourable clinical and radiological progression. Only 2 patients needed admission to the hospital (< 1%). CONCLUSIONS: In community acquired pneumonias studied in our outpatient clinic we found a high number of "atypical" agents. Treatment with macrolids or second generation cephalosporines are appropriate for these patients.
Authors: I Alfageme; J Aspa; S Bello; J Blanquer; R Blanquer; L Borderías; C Bravo; R de Celis; X de Gracia; J Dorca; J Gallardo; M Gallego; R Menéndez; L Molinos; C Paredes; O Rajas; J Rello; F Rodríguez de Castro; J Roig; F Sánchez-Gascón; A Torres; R Zalacaín Journal: Arch Bronconeumol Date: 2005-05 Impact factor: 4.872