Resumo

ARREDONDO BRUCE, Alfredo; REYES OLIVA, Roberto  e  GUERRERO JIMENEZ, Gustavo. Novel aspects of community pneumonia. AMC [online]. 2011, vol.15, n.4, pp. 760-774. ISSN 1025-0255.

Introduction: despite powerful antibiotics, community-acquired pneumonia remains the most common cause of mortality from infectious diseases, and the seventh leading cause of death in the United States. By this reason, interest has been redirected into therapeutic measures apart from antibiotics. Development: a bibliographic review on the topic was made. Despite theoretical benefits, existing literature does not demonstrate good results in therapy with corticosteroids, which large controlled studies are needed. Non-steroidal anti-inflammatory drugs could benefit oxygenation but not show any effect on mortality. The activation of the coagulation system seems to be a very important physiopathological event in severe pneumonia, possibly more than generalized sepsis. The subgroup of acquired pneumonia in the community in phase III of a study using both drotrecogin alpha (activated) and tifacogin (recombinant tissular factor pathway inhibitor) showed a greater benefit. The immunomodulatory effects of macrolide antibiotics may have an important role in the management of severe community-acquired pneumonia. The exogenous tensio-active agent is used as adjunctive therapy for acute inflammatory lesion of the lung. Estatina use before diagnosis is associated with improved outcome but requires further research to determine if the indication at the time of diagnosis will affect the final result. Conclusions: other therapies have theoretical benefit but are still at the stage of clinical trials.

Palavras-chave : PNEUMONIA; MACROLIDES; ANGIOTENSIN-CONVERTING ENSYME INHIBITORS; REVIEW LITERATURE AS TOPIC; COMMUNITY MEDICNE.

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