Update on the pathogenesis and management of pneumonia in the elderly-roles of aspiration pneumonia

Respiratory Investigation
Shinji TeramotoNobuyuki Hizawa

Abstract

Pneumonia in the elderly results in the highest mortality among cases of community-acquired pneumonia (CAP). The pathophysiology of pneumonia in the elderly is primarily due to aspiration pneumonia (ASP). ASP comprises two pathological conditions: airspace infiltration with bacterial pathogens and dysphagia-associated miss-swallowing. The first-line therapy for the treatment of bacterial pneumonia in the elderly is a narrow spectrum of antibiotics, including sulbactam/ampicillin, which are effective against major lower respiratory infection pathogens and anaerobes. The bacterial pathogens of ASP cases of pneumonia in the elderly are similar to those associated with adult CAP. In addition to an appropriate course of antibiotics, pharmacologic and non-pharmacologic approaches for dysphagia and upper airway management are necessary for the treatment and prevention of pneumonia. Swallowing rehabilitation, oral health care, pneumococcal vaccination, gastroesophageal reflux management, and a head-up position during the night are necessary for the treatment and prevention of repeated episodes of pneumonia in elderly patients. In addition, tuberculosis should always be considered for the differential diagnosis of pneumonia in this pati...Continue Reading

References

Oct 1, 1975·Chest·J G Bartlett, S L Gorbach
Jul 1, 1994·American Journal of Respiratory and Critical Care Medicine·R KikuchiH Sasaki
Dec 31, 1997·American Journal of Respiratory and Critical Care Medicine·R RiquelmeN Soler
Oct 6, 1998·Lancet·K SekizawaH Sasaki
Aug 28, 1999·Lancet·T YoneyamaH Sasaki
Oct 26, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·T J Marrie
May 31, 2001·Journal of the American Geriatrics Society·M YamayaH Sasaki
Apr 19, 2002·Gerontology·T MatsuiH Sasaki
Feb 5, 2004·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M AlleweltUNKNOWN Study Group on Aspiration Pneumonia
Feb 11, 2004·Chest·Shinji TeramotoTakeshi Matsuse
Apr 7, 2004·The European Respiratory Journal·B ChristensonA Ortqvist
Jan 20, 2007·Journal of the American Geriatrics Society·Mei HeHiroyuki Arai
Feb 6, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lionel A MandellUNKNOWN American Thoracic Society
Aug 8, 2007·Antimicrobial Agents and Chemotherapy·Scott T MicekMarin H Kollef
Mar 5, 2008·Journal of the American Geriatrics Society·Shinji TeramotoUNKNOWN Japanese Study Group on Aspiration Pulmonary Disease
Jun 28, 2008·BMC Public Health·Olga Ochoa-GondarUNKNOWN EVAN-65 Study Group
Aug 12, 2008·Journal of the American Geriatrics Society·Carol W BassimDonald J Denucci
Aug 14, 2009·Expert Review of Neurotherapeutics·Shinji Teramoto
Dec 10, 2009·Chest·Shinji TeramotoShunsuke Shoji
Jan 12, 2010·Respiratory Medicine·Takaya MaruyamaOsamu Taguchi
Jun 22, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·James D ChalmersAdam T Hill
Aug 20, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Yukie SatouShuhei Yamaguchi
Aug 1, 2012·Archives of Physical Medicine and Rehabilitation·Chia-Wei LinTyng-Guey Wang
Aug 11, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Aiko OsawaNorio Tanahashi
Jan 29, 2013·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Hajime FukuyamaTomoo Kishaba
Apr 4, 2013·Cerebrovascular Diseases·Aiko OsawaNorio Tanahashi
May 7, 2013·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Fumi KarinoTakeshi Isobe
May 23, 2013·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Shigeru KohnoJun-Ichi Kadota
Oct 18, 2013·Geriatrics & Gerontology International·Kaoru MatsusakaMutsuo Yamaya
Feb 18, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Olga Ochoa-GondarImma Hospital-Guardiola
Jan 1, 2013·Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics·Shoko NakataShinji Teramoto
Jun 4, 2014·JAMA : the Journal of the American Medical Association·Eric M MortensenAntonio Anzueto
Jul 19, 2014·Dysphagia·Keisuke Maeda, Junji Akagi

❮ Previous
Next ❯

Citations

Dec 15, 2015·Expert Review of Anti-infective Therapy·Maddalena GiannellaPierluigi Viale
Oct 21, 2016·Journal of the American Geriatrics Society·Petteri SjögrenMaude Wikström
Dec 22, 2016·International Journal of Molecular Sciences·Catia CillonizAntoni Torres
Apr 1, 2017·Clinical Drug Investigation·Leon Fisher, Alexander Fisher
Jun 13, 2017·Expert Opinion on Pharmacotherapy·Diego ViasusJordi Carratalà
Feb 16, 2018·Gerodontology·Shingo NoguchiHiroshi Mukae
Jun 17, 2016·Microbiology and Molecular Biology Reviews : MMBR·Michelle K Paczosa, Joan Mecsas
Dec 7, 2019·Geriatrics & Gerontology International·Tatsuma OkazakiTakae Ebihara
Jul 7, 2020·Geriatrics & Gerontology International·Yuki YoshimatsuYoshitaka Oku
Jan 24, 2018·Journal of Applied Physiology·Takanori TsujimuraMakoto Inoue
Mar 17, 2019·Aging Clinical and Experimental Research·Chien-Ju LinLee-Ching Hwang
Apr 1, 2020·Journal of Oral Science·Takanori Tsujimura, Makoto Inoue
Mar 11, 2020·Aging Clinical and Experimental Research·Yoshimi HidaHisataka Sakakibara
Dec 31, 2016·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Alvisa PaleseUNKNOWN Aspiration Research Team
Apr 3, 2021·Archives of Gerontology and Geriatrics·Keisuke MaedaAkiyoshi Kuroda
Nov 6, 2020·The Journal of Medical Investigation : JMI·Tomoya OmuraMitsugu Naoe
May 14, 2019·Journal of the American Medical Directors Association·Hee-Young YoonYon Ju Ryu
Oct 10, 2021·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Keisuke MaedaAkiyoshi Kuroda

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Bacterial Pneumonia (ASM)

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Bacterial Pneumonia

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.