In primary care in Sweden, the initial antibiotic treatment in any patient with pneumonia should be effective against S. pneumonia and H. influenzae. In addition, M. pneumoniae should be targeted during recurrent epidemics. C. pneumoniae, and especially Legionella, seem to be uncommon in primary care.
The usefulness of non-specific inflammatory parameters for the diagnosis of community- acquired pneumonia (CAP) in primary care is not settled. The aim of this study was to assess the value of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) for this purpose. These inflammatory parameters, as well as the aetiological agents, were studied in 82 patients with radiologically confirmed CAP. CRP was elevated (>5 mg/l) in 76 patients, with a median value of 65 mg/l. 25 patients had a value of over 100 mg/l. In 32 patients the CRP levels were <50 mg/l and in 17 patients they were <20 mg/l. ESR varied from 5 to 100 mm/h, with a median value of 53 mm/h; in 21 patients the value was <30 mm/h. WBC varied from 4.4 to 21.4x10(9)/l, with a median value of 9.8x10(9)/l. No associations between the levels of the inflammatory parameters and the various aetiologies were found. It is concluded that the examined inflammatory parameters did not contribute notably in the routine diagnosis of CAP established by clinical measures.
Clinically important renal impairment is common in old age, especially in the frailest elderly living in nursing homes. This finding underlines the necessity for close supervision of drug treatment based on renal function in old age.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.