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Perspectives

Five steps to reducing risk in community-acquired pneumonia

Alistair Abbott, Lucy Morgan

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© KATERYNA KON/SHUTTERSTOCK
© KATERYNA KON/SHUTTERSTOCK

Abstract

Community-acquired pneumonia (CAP) causes significant morbidity and mortality, particularly among older people and those with chronic disease. We propose a five-point strategy to reduce the risk of CAP, consequent hospitalisation and complications. It includes pneumococcal and influenza vaccinations, minimisation of inhaled corticosteroids, smoking cessation, alcohol reduction and antiplatelet therapy after CAP.

Key Points

  • Community-acquired pneumonia (CAP) is common and causes significant morbidity and mortality, particularly among older people and those with chronic illness.
  • Vaccination against the most common causes of CAP, Streptococcus pneumoniae and influenza virus, reduces CAP incidence substantially.
  • Smoking and alcohol abuse are important risk factors for CAP, and smoking and alcohol harm minimisation strategies are recommended whenever possible.
  • Inhaled corticosteroids may increase CAP risk in patients with chronic obstructive pulmonary disease and should be used only in those who meet local guideline criteria.
  • Evidence is increasing for an association between CAP and cardiovascular events; a course of aspirin should be considered in all patients after CAP.

Figures

© KATERYNA KON/SHUTTERSTOCK
© KATERYNA KON/SHUTTERSTOCK