dc.contributor
Institut Català de la Salut
dc.contributor
[Putot A] Médecine Interne et Maladies Infectieuses, Hôpitaux du Pays du Mont-blanc, Sallanches, France. [Garin N] Department of Internal Medicine, Riviera-Chablais Hospitals, Switzerland. Department of Medicine, Geneva University Hospitals, Switzerland. [Rello J] IMAGINE, UR-UM 107, University of Montpellier, Division of Anaesthesia Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Nîmes, France. Medicine Department, Universitat Internacional de Catalunya, Spain. Grup de Recerca Clínica/Innovació en la Pneumònia i Sèpsia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. [Prendki V] Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland. Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Alain, Putot
dc.contributor.author
Garin, Nicolas
dc.contributor.author
Rello, Jordi
dc.contributor.author
Prendki, Virginie
dc.date.accessioned
2025-10-25T08:54:52Z
dc.date.available
2025-10-25T08:54:52Z
dc.date.issued
2025-05-07T07:40:35Z
dc.date.issued
2025-05-07T07:40:35Z
dc.identifier
Putot A, Garin N, Rello J, Prendki V. Comprehensive management of pneumonia in older patients. Eur J Intern Med. 2025 May;135:14-24.
dc.identifier
http://hdl.handle.net/11351/13046
dc.identifier
10.1016/j.ejim.2025.02.025
dc.identifier.uri
http://hdl.handle.net/11351/13046
dc.description.abstract
Diagnosis; Older people; Pneumonia
dc.description.abstract
Diagnòstic; Gent gran; Pneumònia
dc.description.abstract
Diagnóstico; Personas mayores; Neumonía
dc.description.abstract
Pneumonia is a leading cause of death and functional decline in the older population. Diagnosis of pneumonia conventionally includes the presence of respiratory signs and symptoms, systemic signs of infection and a radiographic demonstration of lung involvement. Pneumonia diagnosis in the very old patient is compromised by atypical and unspecific presentation, resulting in a high proportion of false positive diagnosis. Chest radiograph is frequently of low quality and inconclusive in older patients. Computed tomography scan and chest ultrasound may provide valuable diagnostic confirmation in uncertain cases. Bacterial pneumonia has been mainly studied, but viruses, among which influenza, SARS-CoV-2, and respiratory syncytial virus, are increasingly recognized as major players. The decision to treat pneumonia is usually based on a triple assessment of diagnostic probability, disease severity and the general assessment of the patient (frailty, comorbidities, place of living, and goals of care). Antimicrobial treatment is probabilistic, targeting common pathogens. The optimal antibiotic treatment depends on epidemiological data, setting of acquisition, comorbidities, risk factors for methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, or aspiration pneumonia, and severity. Recent controlled trials have demonstrated the non-inferiority of short regimen in non-severe community acquired pneumonia, even in older individuals and a five-day antibiotic treatment is recommended in case of clinical improvement. Pneumonia management in older patients requires a comprehensive approach, including control of comorbidities (particularly cardiovascular), nutritional support, rehabilitation, and prevention of aspiration. Finally, pneumonia may be a pre-terminal event in many patients, requiring advanced-care planning and prompt instauration of palliative management.
dc.format
application/pdf
dc.relation
European Journal of Internal Medicine;135
dc.relation
https://doi.org/10.1016/j.ejim.2025.02.025
dc.rights
Attribution 4.0 International
dc.rights
http://creativecommons.org/licenses/by/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Medicaments antibacterians - Ús terapèutic
dc.subject
Pneumònia - Diagnòstic
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Pneumònia - Tractament
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Malalties bacterianes
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Pneumònia - Tomografia
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Persones grans
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DISEASES::Bacterial Infections and Mycoses::Bacterial Infections::Pneumonia, Bacterial
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Other subheadings::Other subheadings::/diagnosis
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ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Image Interpretation, Computer-Assisted::Tomography, X-Ray Computed
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CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
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Other subheadings::Other subheadings::/therapeutic use
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NAMED GROUPS::Persons::Age Groups::Adult::Aged
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ENFERMEDADES::infecciones bacterianas y micosis::infecciones bacterianas::neumonía bacteriana
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Otros calificadores::Otros calificadores::/diagnóstico
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TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::interpretación de imágenes asistida por ordenador::tomografía computarizada por rayos X
dc.subject
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos
dc.subject
Otros calificadores::Otros calificadores::/uso terapéutico
dc.subject
DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::adulto::anciano
dc.title
Comprehensive management of pneumonia in older patients
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
