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Rev Esp Quimioter 2022;35(Suppl.1):82-88

Diagnostic and therapeutic approach to occupational pneumonia

PEDRO PABLO ESPAÑA YANDIOLA, ANE URANGA ETXEBERRIA, AMAIA ARTARAZ EREÑO, ANA JODAR SAMPER

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.19.2022

We shall define occupational pneumonia as a disease of external origin, closely tied to the workplace setting and caused by biological microorganisms. The main pathogens are bacteria, fungi and viruses. There are a number of occupations specifically prone to the possibility of acquiring pneumonia when performing work duties.
In addition to the diagnostic methods and drug treatments current in infectious processes, a good clinical history, with avoidance and protection measures would be the most important tools for the management of occupational pneumonia.
Social and demographic changes in the last two decades have made zoonotic infections, and especially viruses, the main cause of new infections. Human health and animal health are closely linked, so collaboration between veterinarians and doctors, together with the necessary environmental respect and conservation, plus the appropriate public policies are essential to avoid these wide negative effects.

Rev Esp Quimioter 2022; 35(Suppl. 1):82-88 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):78-81

Top-ten papers in pneumonia (2020-2021)

SUSANA SANCHO, RUBÉN FORTEA, RUBÉN MARTÍN

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.18.2022

Despite the fact that the last year has been marked by the SARS-CoV-2 pandemic, there have been many articles published on non-COVID pneumonia. Making the selection has not been easy, having based on those articles that we think can bring us some novelty and help in clinical practice. We have divided the selection into seven sections: patient severity, diagnosis, treatment, ventilation, novelties in the guidelines, fungal infection and organ donation.

Rev Esp Quimioter 2022; 35(Suppl. 1):78-81 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):73-77

Aspiration pneumonia

MICHAEL S. NIEDERMAN, CATIA CILLONIZ

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.17.2022

The growing population of older people worldwide represents a great challenge for health systems. The elderly are at increased risk of infectious diseases such as pneumonia, which is associated with increased morbidity and mortality related mainly to age-related physiological changes in the immune system (immunosenescence), the presence of multiple chronic comorbidities, and frailty. In pneumonia, microaspiration is recognized as the main pathogenic mechanism; while macroaspiration which refers to the aspiration of a large amount of oropharyngeal or upper gastrointestinal content passing through the vocal cords and trachea into the lungs is identified as “aspiration pneumonia”. Although there are strategies for the prevention and management of patients with pneumonia that have been shown to be effective in older people with pneumonia, more research is needed on aspiration pneumonia, its risk factors and outcomes, especially since there are no specific criteria for its diagnosis and consequently, the studies on aspiration pneumonia include heterogeneous populations.

Rev Esp Quimioter 2022; 35(Suppl. 1):73-77 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):67-72

Respiratory consequences after COVID-19: outcome and treatment

MARÍA MOLINA-MOLINA, MARTA HERNÁNDEZ-ARGUDO

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.16.2022

The SARS-CoV-2 (COVID-19) pandemic represents the infection with the highest lethality, but also the one that has caused the most sequelae and multi-organ consequences, especially respiratory, in the last century. Several actions have been required in the field of respiratory and intensive care medicine to reduce mortality and chronicity. The consequences of COVID-19 are multiple and encompass different physical, emotional, organizing, and economic aspects, which will require a multidisciplinary, transversal, and collaborative approach. This review includes the observations and results of published retrospective and prospective studies on post-COVID19 respiratory sequelae, especially after severe pneumonia with associated adult respiratory distress syndrome (ARDS).

Rev Esp Quimioter 2022; 35(Suppl. 1):67-72 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):64-66

Respiratory infections in Coronavirus disease 2019

JOSE L. DEL POZO

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.15.2022

In the last two years, the capacity of our hospitals has clearly been overwhelmed due to the COVID-19 pandemic The patient who comes to the hospital with a respiratory coinfection does not have the same characteristics as the patient who suffers a superinfection while hospitalized. The number of secondary infections increase proportionally to the severity of the patient’s disease. Besides, pathogens that cause a coinfection are clearly differentiated from the pathogens that cause a superinfection. However, in patients subjected to airway manipulation, superinfections by distinct pathogens can occur. Seventy five percent of patients admitted worldwide with COVID-19 (especially during the first two waves of the pandemic) received some form of antibiotic treatment during admission. In this context, it is essential to develop and implement algorithms that allow us to define the predictors in each individual case for the development of a superinfection.

Rev Esp Quimioter 2022; 35(Suppl. 1):64-66 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):59-63

Immune treatment in COVID-19

ROSARIO MENÉNDEZ, PAULA GONZÁLEZ, ANA LATORRE, RAÚL MÉNDEZ

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.14.2022

Current immune treatment directed to avoid viral replication relies mainly in convalescent plasma and monoclonal antibodies (mAbs). No clinical benefit for convalescent plasma has been reported in a meta-analysis and systematic review compared to standard of care. MAbs are recombinant proteins capable to bind with SARS-CoV-2 preventing its entrance into cells. Several mAbs have shown reduction in viral load and/or progression of the disease such as casirivimab-imdevimab, bamlanivimab-etesevimab and sotrovimab. After the apparition of Omicron variant, it has been reported that sotrovimab retained its activity whereas the other two combinations exhibited loss of neutralizing activity. Several aspects as the target population, timing and doses, serological patient status and evolution of variants still require attention, monitorization and further studies for knowledge gaps.

Rev Esp Quimioter 2022; 35(Suppl. 1):59-63 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):54-58

Steroid therapy and antiviral treatment in SARS-CoV-2 pneumonia: clinical contexts and indications

ANTONI TORRES, CATIA CILLONIZ

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.13.2022

Critically ill patients with COVID-19 face a higher risk of disease progression and complications. The current standard of care includes supportive care measures and fluid management. The Recovery trial observed a reduction in all-cause, 28-day mortality (p<0.001) when patients with COVID-19 requiring oxygen therapy received 6 mg of dexamethasone per day for 10 days. In contrast, in patients not requiring oxygen, no benefit was observed: 28-day mortality rates for the dexamethasone and routine care groups were 17.8% and 14%, respectively. To corroborate these results, the World Health Organization (WHO) performed a meta-analysis. The study showed that the use of systemic corticosteroids compared with routine care placebo was associated with a decrease in all-cause, 28-day mortality. With respect to the effectiveness of remdesivir, the ACTT-1 trial found that the drug conferred a benefit on time to clinical improvement. The subgroup analysis in the clinical trial also showed a benefit per mortality in patients requiring supplemental oxygen, albeit not those in need of mechanical ventilation.

Rev Esp Quimioter 2022; 35(Suppl. 1):54-58 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):50-53

Ventilation support in SARS-CoV-2 pneumonia. Strategy and indications

FEDERICO GORDO, LAURA PARRO, MOHAMED MOHAMED

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.12.2022

The SARS-CoV2 pandemic has generated a need for knowledge, new concepts in pathophysiology and an increase of the use of respiratory support in highly complex patients. This fact has provoked the need to evolve to the concept of personalized ventilatory support according to the patient’s response to treatment.

Rev Esp Quimioter 2022; 35(Suppl. 1):50-53 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):46-49

New evidence in severe pneumonia: imipenem/ cilastatin/relebactam

ROSA Mª GIRÓN, AMPARO IBÁÑEZ, ROSA MAR GÓMEZ-PUNTER, TERESA ALARCÓN

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.11.2022

Imipenem combined with beta-lactamase inhibitor relebactam (IMI/REL) has an extensive bactericidal activity against Gram-negative pathogens producing class A or class C beta-lactamases, not active against class B and class D. The phase 3 clinical trial (RESTORE-IMI-2), double-blind, randomized, evaluated IMI/REL vs. piperacillin-tazobactam (PIP/TAZ) for treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), demonstrated non-inferiority at all-cause mortality at 28 days (15.9% vs 21.3%), favorable clinical response at 7-14 days end of treatment (61% vs 59.8%) and with minor serious adverse effects (26.7% vs 32%). IMI/REL is a therapeutic option in HAP and VAP at approved dosage imipenem 500 mg, cilastatin 500 mg and relebactam 250 mg once every 6h, by an IV infusion over 30 min.

Rev Esp Quimioter 2022; 35(Suppl. 1):46-49 [Full-text PDF]


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Rev Esp Quimioter 2022;35(Suppl.1):43-45

New evidence in severe pneumonia: meropenem-vaborbactam

MARÍA FORTEZA GUILLOT, MARÍA MARTÍN CEREZUELA, PAULA RAMÍREZ

Published: 22 April 2022

http://www.doi.org/10.37201/req/s01.10.2022

The appearance and spread of new mechanisms of bacterial resistance to antibiotics is a serious health problem. One of the most difficult resistance mechanisms to treat is the production of carbapenemases. Carbapenemase KPC is one of those mechanisms with few therapeutic options. Meropenem-vaborbactam has shown great efficacy against this type of microorganism, both from a clinical and microbiological point of view. Its good pharmacokinetics, including in the lung, and its safety profile make meropenem-vaborbactam an excellent therapeutic option. Finally, the absence of resistance genesis during treatment seems to indicate that its efficacy will be long-lasting.

Rev Esp Quimioter 2022; 35(Suppl. 1):43-45 [Full-text PDF]


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