Pneumonia risk factors

Dementia due to AD steadily worsens, typically over the course of about 10 years, but survival in some patients may be as short as 3 4 years. In late stages AD leads to what is sometimes called a vegetative state, Le. the patient is bedfast and totally dependent on others for all basic living activities. Patients with AD typically die from bronchitis or pneumonia. Risk factors of AD are age, female gender and presence of the apolipoprotein c4 (APO e4) allele. Higher levels of education, moderate levels of daily wine consumption and higher levels of fish in the diet have been associated with a lower risk for AD (Cummings and Cole, 2002). 

Unless risk factors for infection owing to potentially antibiotic-resistant bacteria ° Late-onset hospital-acquired pneumonia... 

The mean survival time of persons with AD is reported to be approximately 6 years from the onset of symptoms until death. However, age at diagnosis, severity of AD, and other medical conditions affect survival time.8 Although AD does not directly cause death, it is associated with an increase in various risk factors which often contribute to death such as senility, sepsis, stroke, pneumonia, dehydration, and decubitus ulcers. 

Aspiration of the oropharyngeal or gastric contents may lead to aspiration pneumonia or chemical (acid) pneumonitis. Risk factors for aspiration include... 

Community-acquired pneumonia Health care-associated, ventilator-asociated, or nosocomial pneumonia (Early onset no risk factors for MDR pathogens) Third-generation cephalosporin plus a macrolide or doxycycline Third-generation cephalosporin OR Fluoroquinolone OR Ampicillin-sulbactam OR Ertapenem... 

Health care-associated, ventilator-associated, or nosocomial pneumonia (Late onset and/or MDR pathogen risk factors) Antipseudomonal penicillin OR Antipseudomonal cephalosporin OR Antipseudomonal carbapenem plus Aminoglycoside OR Antipseudomonal fluoroquinolone plus Vancomycin or linezolid... 

Treatment for septic patients with hospital-acquired, ventilator-acquired, and health care-associated pneumonia is dependent on risk factors for multi-drug resistant (MDR) organisms (Fig. 79-2). Recommended treatment for patients with no MDR risk factors are third-generation cephalosporins, fluoroquinolones, ampicillin-sulbactam, or ertapenem (see Table 79-3).35 Recommended treatment for patients with MDR risk factors are P-lactam/p-lactamase inhibitors (piperacillin-tazobactam), antipseudomonal cephalosporin, or carbapenem, plus an aminoglycoside, plus vancomycin or linezolid (see Table 79-3).35 If an aminoglycoside is undesirable, a antipseudomonal fluoroquinolone may be utilized with a P-lactam/p-lactamase inhibitor. 

It is widely accepted that cigarette smoking is linked to community acquired pneumonia and is one of the major risk factors for respiratory infections.39,40 Cigarette smoke is composed of two components, the vapor and particulate phase. The immunosuppressive effect of tobacco smoke is partly due to nicotine, which occurs in the particulate portion. Nicotine, as well as other immunotoxins in tobacco smoke, are thought to be respon-... 

Almirall, J. et al., Risk factors for community-acquired pneumonia in adults a population-based case-control study, Eur. Respir. J., 13, 349, 1999. 

Pneumonia - Do not use oral azithromycin in patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate to severe illness or risk factors such as any of the following nosocomially acquired infections known or suspected bacteremia conditions requiring hospitalization cystic fibrosis significant underlying health problems that may compromise patients ability to respond to their illness (including immunodeficiency or functional asplenia) elderly or debilitated patients. 

Ortqvist, A., Hedlund, J., and Kalin, M. (2005) Streptococcus pneumoniae epidemiology, risk factors, and clinical features. Semin Respir Crit Care Med. 26, 563-574. 

Chevret S., HemmerM., Carlet J., and Langer M. (1993) Incidence and risk factors of pneumonia acquired in intensive care units results from a multicenter prospective study on 996 patients. Intens. Care Med. 19, 256-264. 

Gil-Nunez AC, Vivancos-Mora J (2005). Blood pressure as a risk factor for stroke and the impact of antihypertensive treatment. Cerebrovascular Diseases 20 40-52 GISSI-Prevenzione Investigators (1999). Dietary supplementation with -3 polyunsaturated fatty acids and vitamin E after myocardial infarction results of the GISSI-Prevenzione trial. Lancet 354 447-455 Glader CA, Stegmayr B, Boman J et al. (1999). Chlamydia pneumoniae antibodies and high lipoprotein (a) levels do not predict ischemic cerebral infarctions results from a nested case-control study in northern Sweden. Stroke 30 2013-2018... 

Strachan DP, Carrington D, Mendall MA et al. (1999). Relation of Chlamydia pneumoniae serology to mortality and incidence of ischemic heart disease over 13 years in the Caerphilly Prospective Heart Disease Study. British Medical Journal 318 1035-1039 Stroke Prevention in Atrial Fibrillation Investigators (1992). Predictors of thromboembolism in atrial fibrillation II Echocardiographic features of patients at risk. Annals of Internal Medicine 116 6-12 Stroke Prevention in Atrial Fibrillation Investigators (1995). Risk factors for thromboembolism during aspirin therapy in patients with atrial fibrillation the Stroke Prevention in Atrial Fibrillation Study. Journal of Stroke and Cerebrovascular Disease 5 147-157... 

Scott JA, Hall AJ, Muyodi C, Lowe B, Ross M, Chohan B, Mandaliya K, Getambu E, Gleeson F, Drobniewski F, Marsh K. Aetiology, outcome, and risk factors for mortality among adults with acute pneumonia in Kenya. Lancet 2000 355(9211) 1225-30. 

Krebs S, Gibbons RB. Low-dose methotrexate as a risk factor for Pneumocystis carinii pneumonia. Mil Med 1996 161(l) 58-60. 

O Brien JG, Dong BJ, Coleman RL,Gee L, Balano KB. A 5-year retrospective review of adverse drug reactions and their risk factors in human immunodeficiency virus-infected patients who were receiving intravenous pentamidine therapy for Pneumocystis carinll pneumonia. Clin Infect Dis. 1997 May 24(5) 854-9. 

Waskin El, Stehr-GreenJK, ElelmickCG,SattlerER. Risk factors for hypoglycemia associated with pentamidine therapy for Pneumocystis pneumonia. Jama. 1988Jul 15 260(3) 345-7. 

Bonten MJ, Bergmans DC, Ambergen AW, et al. Risk factors for pneumonia and colonization of respiratory tract and stomach in mechanically ventilated ICU patients. Am J Respir Crit Care Med 1996 154 1339-1346. 

Use of parenteral azithromycin for the treatment of CAP was approved in the United States based on the results of two large clinical trials in hospitalized patients with CAP, including a large comparative trial where azithromycin was shown to be as effective as cefuroxime with or without erythromycin [218]. Parenteral formulation of azithromycin is currently approved in the United States for mild to moderate pneumonia in adults due to C. pneumoniae, Mycobacterium pneumoniae, Legionella pneumophila, Moraxella catarrhalis, S. aureus, or S. pneumoniae in hospitalized patients who require initial parenteral therapy. The recommended regimen is 500 mg daily for at least 2 days, followed by daily oral azithromycin to complete a 7- to 10-day course. Due to the rising rates of macrolide-resistant S. pneumoniae in some areas, physicians should avoid using I.V. azithromycin as monotherapy in patients with severe CAP, particularly in a very ill patient with multiple comorbidities with known risk factors for penicillin-resistant... 

---