oa South African Family Practice - CPD editorial
Once again we have succeeded in putting together a set of interesting articles which are relevant and topical for the family practitioner. The article on community-acquired pneumonia (CAP) by AD Black emphasizes the importance of CAP as an important cause of morbidity and mortality in the general population especially in the very young and elderly. It is interesting to note that no obvious predisposing cause is apparent in the majority of cases and even with extensive investigations; a causative agent is not identified in 98% of outpatients and 40-50% of inpatients. In those who a causative agent is found, Streptococcus pneumonia is still the predominant organism. The clinical scores proposed to differentiate between viral and bacterial CAP are neither sensitive nor specific for clinical practice, although the Bartlett score is still used for identifying specimens from lower respiratory tracts. The algorithm produced with permission from S Afr Med J summarizes the South African Thoracic Society's guideline for the management of CAP. The article covers the wide range of antibiotic regimen with the combination of amoxicillin-clavulanate still favoured as first line treatment in most cases of CAP.
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