Zusammenfassung
Die ambulant erworbene Pneumonie ist eine Erkrankung mit einer hohen Morbidität und Letalität und damit erheblichen Kosten für das Gesundheitssystem. Da sie überwiegend eine Erkrankung des älteren Menschen ist, wird ihre Bedeutung aufgrund des demographischen Wandels weiter zunehmen. Die Einführung der modernen Antibiotikatherapie hat die Prognose der Pneumonie deutlich gebessert, jedoch stehen wir neuen Problemen und Herausforderungen wie mehr multimorbiden Patienten und antibiotikaresistenten Erregern gegenüber. Gerade im Hinblick auf die Antibiotikatherapie älterer Menschen gibt es keine zuverlässigen Studienergebnisse. Dennoch haben eine verbesserte Diagnostik und die Einführung risikostratifizierter Therapiemaßnahmen zu einer Vereinheitlichung der Therapie und damit besseren Versorgungsqualität beigetragen. Impfstrategien haben sich für bestimmte Erreger bewährt.
Abstract
Community-acquired pneumonia is a disease with high morbidity and mortality and, therefore, has an enormous impact on health care costs. Pneumonia is mainly a disease of the elderly. Therefore, due to the dramatic change in demography of the general population, the importance of pneumonia will increase rapidly. The development of modern antibiotic therapy has improved the prognosis of pneumonia patients; however, there are also new challenges and problems, e.g., increased numbers of comorbid patients and the appearance of antibiotic resistance. In regard to antibiotic treatment of the elderly, evidence from randomized controlled clinical studies is missing. Nevertheless, the improvement in diagnosis and the introduction of risk stratification approaches have led to a standardization in therapy and better quality of care in Germany. Vaccination strategies for special pathogens, e.g., S. pneumoniae, reduced the burden of disease.
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Der korrespondierende Autor weist auf folgende Beziehungen hin: Er hat Honorare für Vorträge von Pfizer, Bayer, MSD, AstraZeneca und Sanofi-Aventis erhalten.
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Welte, T. Ambulant erworbene Pneumonie. Z Gerontol Geriat 44, 221–228 (2011). https://doi.org/10.1007/s00391-011-0183-4
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DOI: https://doi.org/10.1007/s00391-011-0183-4