Çocukluk Çağında Toplum KökenliPnömoninin Ayaktan Tedavisi

ÖzToplum kökenli pnömoni (TKP) tüm dünyada özellikle gelişmekte olan ülkelerde yaşayan 5 yaşın altındaki çocuklarda önemli düzeyde solunumsal morbidite vemortalite nedeni olan bir halk sağlığı sorunudur. TKP dünya çapında 5 yaşından küçük çocuklarda önde gelen ölüm nedenidir. Çocuklarda TKP tanısında hastaların klinik bulguları önemlidir. Sık rastlanan bulgular arasında ateş, takipne, artmış solunum çabası, ronkuslar, raller ve vizing yeralır. Hidrasyon durumu, aktivite düzeyi ve oksijen satürasyonu da önemlidir ve hastaneye yatma ihtiyacını gösterebilir.Ayaktan verilen ampirik oral antimikrobiyal tedavi alt solunum yolu enfeksiyonlarının en sık nedeni olan bakteriyel patojenlere ve özellikle de tedavi edilmediğinde veya yetersiz tedavide ağır sekele yol açabilecek bir bakteriyel patojen olan S. pneumoniae’ya karşı etkili bir tedavi sağlamaya yönelik olarak planlanmaktadır. Bu yazıda toplum kökenli pnömoni tanısı konulan ancak hastaneye yatış endikasyonu ol-mayan çocuk hastalarda en sık rastlanan etkenler, tanı kriterleri ve ampirik ve etkene yönelik ayaktan tedavi seçenekleri anlatılmıştır.

Anahtar Kelimeler:

Antimikrobiyal, ayaktan, çocuk, toplum kökenli pnömoni

Outpatient Treatment of Community-AcquiredPneumonia in Children

AbstractCommunity-acquired pneumonia (CAP) is a public health problem all over theworld, that is a significant cause of respiratory morbidity and mortality especiallyin children under age 5 living in developing countries. CAP is the leading cause of death worldwide in children younger than 5 years old.Clinical findings of the patients are important in the diagnosis of CAP in children. Common symptoms include fever, tachypnea, increased respiratory effort, rhonchi, crackles and wheezing. Hydration status, activity level and oxygen saturation ofthe patient are also important and may indicate the need for hospitalization.The outpatient administration of empirical oral antimicrobial treatment is oftenplanned in order to provide an effective treatment against the bacterial pathogens thatare the most common causes of lower respiratory tract infection and especially against S. pneumoniae, a bacterial pathogen, which if untreated or inadequately treated, can cause severe sequels. In this article, the most common pathogens, diagnostic criteria and empirical and agentspecific outpatient treatment options for pediatric patientsdiagnosed with community-acquired pneumonia with noindication of hospitalization have been described.

Keywords:

Antimicrobial, community-acquired pneumonia, outpati-ent, pediatric,

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