RT Journal Article
T1 Community-acquired pneumonia - An EFIM guideline critical appraisal adaptation for internists.
A1 Er, Ahmet Gorkem
A1 Alonso, Alberto Antonio Romero
A1 Marin-Leon, Ignacio
A1 Sayiner, Abdullah
A1 Bassetti, Stefano
A1 Demirkan, Kutay
A1 Lacor, Patrick
A1 Lode, Hartmut
A1 Lesniak, Wiktoria
A1 Tanriover, Mine Durusu
A1 Kalyoncu, Ali Fuat
A1 Merchante, Nicolás
A1 Unal, Serhat
K1 Clinical guideline
K1 Community-acquired-pneumonia
K1 Drug interactions
K1 Guideline adaptation
K1 Multimorbidity
K1 Treatment
K1 internal medicine
AB In real-life settings, guidelines frequently cannot be followed since many patients are multimorbid and/or elderly or have other complicating conditions which carry an increased risk of drug-drug interactions. This document aimed to adapt recommendations from existing clinical practice guidelines (CPGs) to assist physicians' decision-making processes concerning specific and complex scenarios related to acute CAP. The process for the adaptation procedure started with the identification of unsolved clinical questions (PICOs) in patients with CAP and continued with critically appraising the updated existing CPGs and choosing the recommendations, which are most applicable to these specific scenarios. Seventeen CPGs were appraised to address five PICOs. Twenty-seven recommendations were endorsed based on 7 high, 9 moderate, 10 low, and 1 very low-quality evidence. The most valid recommendations applicable to the clinical practice were the following ones: Respiratory virus testing is strongly recommended during periods of increased respiratory virus activity. Assessing the severity with a validated prediction rule to discriminate where to treat the patient is strongly recommended along with reassessing the patient periodically for improvement as expected. In adults with multiple comorbidities, polypharmacy, or advanced age, it is strongly recommended to check for possible drug interactions before starting treatment. Strong graded recommendations exist on antibiotic treatment and its duration. Recommendations on the use of biomarkers such as C-reactive protein or procalcitonin to improve severity assessment are reported. This document provides a simple and reliable updated guide for clinical decision-making in the management of complex patients with multimorbidity and CAP in the real-life setting.
YR 2022
FD 2022-10-19
LK http://hdl.handle.net/10668/22185
UL http://hdl.handle.net/10668/22185
LA en
DS RISalud
RD Apr 6, 2025