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How and when to use common biomarkers in community-acquired pneumonia

机译：在社区获得性肺炎中如何以及何时使用常见生物标志物

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Community-acquired pneumonia (CAP) is a leading cause of death in both the developed and developing world. The very young and elderly are especially vulnerable. Even with appropriate early antibiotics we still have not improved the outcomes in these patients since the 1950s, with 30-day case fatality rates of between 10–12%. Interventions to improve outcomes include immunomodulatory agents such as macrolides and corticosteroids. Treating doctors identify CAP patients who are likely to have poor outcomes by using severity scores such as the pneumonia severity index and CURB-65, which allows these patients to be placed in ICU settings from the start of the admission. Another novel way to identify these patients is with the use of biomarkers. This review illustrates how various biomarkers have been shown to predict mortality, complications and response to treatment in CAP patients. The evidence using either procalcitonin or C-reactive protein to demonstrate response to treatment and hence that the antibiotics chosen are appropriate can play an important role in antibiotic stewardship.
机译：在发达国家和发展中国家，社区获得性肺炎（CAP）都是导致死亡的主要原因。年轻人和老年人特别脆弱。自1950年代以来，即使使用了适当的早期抗生素，我们仍未改善这些患者的预后，其30天病死率在10％至12％之间。改善结局的干预措施包括免疫调节剂，例如大环内酯类和皮质类固醇。通过使用严重程度评分（例如肺炎严重程度指数和CURB-65），治疗医生可以识别出可能会导致不良结局的CAP患者，从而使这些患者从入院开始就被放置在ICU中。识别这些患者的另一种新颖方法是使用生物标志物。这篇综述阐明了各种生物标记物如何显示出可预测CAP患者的死亡率，并发症和对治疗的反应。使用降钙素原或C反应蛋白来证明对治疗的反应的证据，因此所选择的抗生素是合适的，可以在抗生素管理中发挥重要作用。

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