Bacterial pneumonia. Managing a deadly complication of influenza in older adults with comorbid disease.

In patients with Influenza, the risk of death from pneumonia is closely associated with age and chronic conditions. Mortality from influenza and pneumonia in Americans age > or = 65 has been increasing since 1980. Pneumonia following influenza is usually caused by a secondary bacterial infection. Pathogens most commonly implicated are Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae. Prompt empiric therapy effective against the suspected pathogen is indicated, whether the patient is being treated as an outpatient or requires inpatient observation or hospitalization for i.v. administration. Influenza vaccination of older patients living in the community has been shown to decrease hospitalizations for influenza and pneumonia by 52% and mortality by 70% in those with chronic lung disease. Protective rates are similar for residents of long-term care facilities.