Community-acquired pneumonia: current data
A new term was introduced in 2005 from the American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA): health-care associated pneumonia (HCAP) which seems to have been established in Greek medical society. Patients who are included in this subcategory of community acquired pneumonia (CAP) present increased rates of multi-drug resistant pathogens and as a result the initial empirical antibiotic treatment is often ineffective. This could be the cause of increased mortality and so, it is advised to provide broad-spectrum antibiotic treatment that covers multi-drug resistant pathogens. However there are many studies that object to this category and prove that the broad-spectrum management leads to overtreatment, resistance and increased mortality. In this review we refer to these studies leading to the questioning of this subcategory. It seems that the classic triad can include all pneumonia categories. However, there is certainly the need to include also new conditions that concern the great increase of elderly patients and the need for evaluation of the functional status and the aspiration that were not till now taken into account.