Predictors of treatment failure and clinical stability in patients with community acquired pneumonia

Abstract

Community acquired pneumonia (CAP) is the leading infectious cause of mortality worldwide with approximately 10% of patients hospitalized requiring intensive care unit (ICU) admission. The ability to predict clinical stability (CS) and treatment failure (TF) enables the clinician to alter antibiotics appropriately, facilitate a timely ICU admission, or arrange a suitable discharge. The detection of CS and TF can be difficult and changes in clinical signs may be subtle or delayed. Thus clinical scores and biomarkers are routinely used to identify severity and monitor clinical progression. The evidence, however, is vast and the definitive role of these systems is at times difficult to elucidate. The aim of this review is to analyse the current literature and to provide a rational and clinically focused view of the predictive utility of various systems used to identify CS and TF in CAP.

Plasma Soluble Urokinase-Type Plasminogen Activator Receptor Level as a Predictor of the Severity of Community-Acquired Pneumonia

“…However, these indices can only be obtained through the collection of a substantial amount of clinical and examination data. Hence, numerous studies have investigated the feasibility of using relatively convenient biomarkers such as white blood cell count, C reactive protein, and procalcitonin as tools to predict CAP severity [23,24,25]. Although white blood cell count and C reactive protein have been applied to numerous clinical examinations, they are still incapable of estimating CAP severity and mortality risk.…”

Cytokines and Cortisol – predictors of treatment response to corticosteroids in community‐acquired pneumonia?

“…However, the positive effect of prednisone did not reach statistical significance. It is well known that high cytokine levels predict worse outcome . However, to the best of our knowledge, it has never been reported that higher cytokines on admission predict a better treatment response to adjunctive prednisone in patients with CAP.…”

Predictors of urinary tract infection in acute stroke patients

“…C-reactive protein can be detected at 4 to 6 hours and reaches its maximum at 36 to 50 hours. [ 48 ] Because the blood of the patients we tested was taken the morning after admission. This phenomenon may explain that the C-reactive protein did not differ significantly between infected and non-infected groups in this study ( P = .740).…”