Refining treatments for pneumonia
Point-of-care ultrasound, cortecosteroids and other treatments could shed new light on this age-old condition.
Pneumonia is one of the most common conditions encountered by hospitalists. But the guidelines and treatment for pneumonia have changed, and the issue of appropriate use of antibiotics is more critical than ever.
“We continue to overtreat pneumonia — both in the use of broad-spectrum antibiotics and in the duration of therapy,” said Joanna Bonsall, MD, PhD, SFHM. “We have good evidence to show that inappropriately prolonged durations of treatment lead to adverse events.”
Some of that evidence was presented in 2019, when the American Thoracic Society and the Infectious Disease Society of America issued guidelines for community-acquired pneumonia. Dr. Bonsall, who is chief of hospital medicine at Grady Memorial Hospital in Atlanta and associate professor of medicine at Emory University, said she’ll discuss a number of changes that have been made since then along with the latest updates in pneumonia treatment in Monday’s session, “Pneumonia: Updates, Best Practices and Controversies.”
“Specifically, I’ll talk about new evidence that impacts the way we both diagnose and treat pneumonia,” she said. “I’ll also review some of the basics, such as the duration of pneumonia treatment.”
One changing area of pneumonia treatment, Dr. Bonsall said, is the use of point-of-care ultrasound.
“Point-of-care ultrasound is also being increasingly utilized to diagnose many different pulmonary conditions, and it can do so quickly and without exposing the patient to radiation,” she said. “And there has been new evidence impacting how we might incorporate corticosteroids into our pneumonia treatment plan.”
Although the use of corticosteroids has been controversial in recent years, Dr. Bonsall said recent evidence sheds light on the debate, along with other areas of controversy including whether or not to use procalcitonin in assessing the need for (and duration of) antibiotics.
Controversy or not, Dr. Bonsall said the search continues for the best treatments for this all-to-common condition.
“I think as clinicians it’s natural to want to find a test or treatment that will help improve pneumonia, even if the ones in front of us aren’t the best fit,” she said.
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