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New horizons in hospital acquired pneumonia in older people

Lookup NU author(s): Dr Vicky Ewan, Dr Tom Hellyer, Emerita Professor Julia Newton

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Abstract

© The Author 2017. Approximately 1.5% of hospital patients develop hospital acquired pneumonia. Aspiration is the major risk factor for pneumonia and is associated with reduced ability to mechanically clear respiratory pathogens into the stomach. Currently non-invasive methods of diagnosing hospital acquired pneumonia are less robust than invasive methods, and lead to over-diagnosis. Accurate diagnosis is key to surveillance, prevention and treatment of HAP, and also to improving outcomes; newer imaging modalities such as phase contrast X-ray imaging and nanoparticle enhanced magnetic resonance imaging may help. Potential preventative strategies such as systematic swallowing assessment in non-stroke patients, and interventions such as improving oral hygiene need further, robust randomised controlled trials. Antibiotics are likely to continue to be the mainstay of treatment, and new antibiotics such as ceftobiprole are likely to have a role in treating hospital acquired pneumonia. Given the spread of antimicrobial resistance, alternative treatment strategies including bacteriophages, peptides and antibodies are under investigation. Reducing the incidence of hospital acquired pneumonia could decrease length of hospital stay, reduce inappropriate antibiotic use, and both improve functional outcomes and mortality in our increasingly aged population.

Publication metadata

Author(s): Ewan V, Hellyer T, Newton J, Simpson J

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2017

Volume: 46

Issue: 3

Pages: 352-358

Print publication date: 01/05/2017

Online publication date: 27/02/2017

Acceptance date: 09/01/2017

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press

URL: https://doi.org/10.1093/ageing/afx029

DOI: 10.1093/ageing/afx029

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