Influence of age in the clinical differentiation of atypical pneumonia in adults
Naoyuki Miyashita1, Yasuhiro Kawai2, Mika Kubo2, Kazunobu Ouchi2 and Niro Okimoto1
Background and objective: The Japanese Respiratory Society (JRS) scoring system is a useful tool in the early and simple presumptive diagnosis of atypical pneumonia, Mycoplasma pneumoniae and Chlamydia pneumoniae pneumonia. However, it has been suggested that it seems to be difficult to diagnose atypical pneumonia in the elderly using this system. In the present study, we evaluated the accuracy and usefulness of the JRS scoring system in the different age groups.
Methods: We analyzed 262 cases of M. pneumoniae, 98 cases of C. pneumoniae and 364 cases of common bacterial pneumonia.
Conclusions: Our results indicate that it is difficult to distinguish between atypical pneumonia and bacterial pneumonia in the elderly using the JRS scoring system. When treating patients aged ≥60 years, physicians should choose fluoroquinolones or β-lactams + macrolides as empirical first-choice drugs, so as to always include potential antibiotic cover for atypical pathogens.
PDPI Surakarta. 05/04/18.
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