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Do not recommend routinely offering microbiological tests to patients with low‑severity community‑acquired pneumonia.
NICE
National Institute for Health and Clinical Excellence (NICE)
For patients with moderate‑ or high‑severity community‑acquired pneumonia: - take blood and sputum cultures and - consider pneumococcal and legionella urinary antigen tests.
ver más ... 2019Do recommend determining whether patients are at low, intermediate or high risk of death using the CURB65 score when a diagnosis of community-acquired pneumonia is made at presentation to hospital.
NICE
National Institute for Health and Clinical Excellence (NICE)
CURB65 score for mortality risk assessment in hospital CURB65 score is calculated by giving 1 point for each of the following prognostic features: - confusion (abbreviated Mental Test score 8 or less, or new disorientation in person, place or time) - raised blood urea nitrogen (over 7 mmol/litre) - raised respiratory rate (30 breaths per minute or more) - low blood pressure (diastolic 60 mmHg or less, or systolic less than 90 mmHg) - age 65 years or more. Patients are stratified for risk of ...
ver más ... 2019Do recommend determining whether patients are at low, intermediate or high risk of death using the CRB65 score when a clinical diagnosis of community-acquired pneumonia is made in primary care.
NICE
National Institute for Health and Clinical Excellence (NICE)
CRB65 score for mortality risk assessment in primary care CRB65 score is calculated by giving 1 point for each of the following prognostic features: - confusion (abbreviated Mental Test score 8 or less, or new disorientation in person, place or time) - raised respiratory rate (30 breaths per minute or more) - low blood pressure (diastolic 60 mmHg or less, or systolic less than 90 mmHg) - age 65 years or more. Patients are stratified for risk of death as follows: - 0: low risk (less than 1% ...
ver más ... 2019Do recommend considering testing C‑reactive protein in people presenting with symptoms of lower respiratory tract infection in primary care, if after clinical assessment a diagnosis of pneumonia ...
NICE
National Institute for Health and Clinical Excellence (NICE)
Use the results of the test to guide antibiotic prescribing in people without a clinical diagnosis of pneumonia as follows: - do not routinely offer antibiotic therapy if the C‑reactive protein concentration is less than 20 mg/litre. - consider a delayed antibiotic prescription (a prescription for use at a later date if symptoms worsen) if the C‑reactive protein concentration is between 20 mg/litre and 100 mg/litre. - offer antibiotic therapy if the C‑reactive protein concentration is ...
ver más ... 2019Do recommend offering an antibiotic(s) for adults, young people and children with hospital-acquired pneumonia. When choosing an antibiotic(s), take account of:
NICE
National Institute for Health and Clinical Excellence (NICE)
- the severity of symptoms or signs - the number of days in hospital before onset of symptoms - the risk of developing complications, for example, if the person has a relevant comorbidity such as severe lung disease or immunosuppression - local hospital and ward-based antimicrobial resistance data - recent antibiotic use - recent microbiological results, including colonisation with multidrug-resistant bacteria - recent contact with a health or social care setting before current admission - the ...
ver más ... 2019