Therapeutic Response of Community Acquired Pneumonia in Geriatrics: A Case Series from Intensive Care Unit
Abstract
Community acquired pneumonia (CAP) is a common major growing challenge to elderly populations. Several aging factors, including comorbidities, nutritional status and digestive dysfunctions have been associated with increasing CAP among older persons. Furthermore, Streptococcus pneumoniae remains the most predominant pathogen in geriatrics, although multiple drug resistance (MDR) species regularly occur, particularly in severe pneumonia. Broad-spectrum antibiotics or a combination of β-lactam and fluorokuinolones, or β-lactams and macrolides serve as a promising therapy mainly in critical CAP patients. This study describes two geriatric CAP cases representing two separate treatments with widely varied results. The combination of cefoperazone sulbactam-azithromycin did not generate suitable clinical response until 7 days. As a consequence, the macrolides were replaced with amikacin and continued for 3 days. Meanwhile, the cefoperazone sulbactam-levofloxacin samples significantly improved the clinical conditions under 9 days. The selection of antibiotics with sufficient lung penetration is important in providing the effective therapy. Conversely, azithromycin resistance potentially instigates ineffectiveness, but is also recommended due to its pleiotropic effects. The benefit of this case study shows that CAP treatment among older population requires a blend of antibiotics with either a fluorokuinolone or an aminoglycoside. In both instances, azitromisin is believed to…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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