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Pneumonia adquirida na comunidade: abordagem terapêutica na idade pediátrica
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Abstract(s)
A pneumonia é uma infeção do trato respiratório inferior que pode ser provocada por
agentes patogénicos como fungos, vírus ou bactérias. Atinge, anualmente, milhões de pessoas
no mundo e apresenta maior predominância e taxa de mortalidade em regiões subdesenvolvidas,
nomeadamente, a África Subsariana e o Sudeste Asiático.
A pneumonia adquirida na comunidade é um dos tipos mais comuns de pneumonia.
Desenvolve-se na comunidade ou até 48 horas após a admissão em meio hospitalar,
considerando o doente que não habita em lares ou outras instituições equivalentes. Esta
patologia é considerada uma das principais causas de morbilidade e mortalidade pediátrica, no
entanto, tem-se registado uma melhoria considerável, ao longo dos anos, deste quadro clínico.
Dependendo da decisão médica, o tratamento pode ser realizado tanto em regime
ambulatorial como em regime de internamento hospitalar. Na pneumonia adquirida na
comunidade destaca-se a pneumonia viral, bacteriana e atípica e, dependendo do agente
etiológico, existem diversas opções terapêuticas. Em caso de suspeita de pneumonia viral
podem ser instituídos antivirais. Se existir suspeita de etiologia bacteriana, é iniciada a
antibioterapia empírica, tendo como primeira linha a amoxicilina. Se, depois de verificada a
idade e analisados outros fatores, existir suspeita de que se trata de um agente etiológico atípico,
são prescritos macrólidos como primeira linha de tratamento.
Quase todas as mortes associadas a esta infeção, principalmente até aos 5 anos de idade,
podem ser evitadas através da implementação de várias estratégias de prevenção. É fundamental
a redução de fatores de risco de modo que ocorra uma diminuição da morbilidade e mortalidade
associadas a esta doença.
Neste contexto, este trabalho de dissertação teve como objetivo a abordagem da
terapêutica atualmente implementada na pneumonia adquirida na comunidade na idade
pediátrica, relevando o papel fundamental do farmacêutico na prevenção e tratamento, bem
como, na educação para a saúde, alertando os progenitores para as eventuais consequências da
evolução deste tipo de pneumonia.
Pneumonia is an infection of the lower respiratory tract that can be caused by pathogenic agents, such as fungi, viruses or bacterias. Anually, it affects millions of people in the world and has a higher prevalence and mortality rate in underdeveloped regions, namely, Sub-Saharan Africa and Southeast Asia. Community-acquired pneumonia is one of the most common types of pneumonia. It develops in the community or up to 48 hours after admission to a hospital, considering the patient who doesn’t live in nursing homes or other equivalent institutions. This pathology is considered one of the main causes of pediatric morbidity and mortality, however, there has been considerable improvement over the years in this clinical picture. Depending on the medical decision, the treatment can be carried out either in an outpatient or in-patient setting. In community-acquired pneumonia, viral, bacterial and atypical pneumonia stand out and, depending on the etiologic agent, there are several therapeutic options. If viral pneumonia is suspected, antivirals can be instituted. If bacterial etiology is suspected, empirical antibiotic therapy is started, with amoxicillin as the first line. If, after checking the patient's age and analyzing other factors, there is a suspicion that it is an atypical etiological agent, macrolides are prescribed as the first line of treatment. Almost all deaths associated with this infection, especially up to 5 years of age, can be avoided by implementing various prevention strategies. It is essential to reduce risk factors so there is a decrease in morbidity and mortality associated with this disease. In this context, this dissertation work aimed to approach the therapy currently implemented in community-acquired pneumonia in pediatric age, highlighting the fundamental role of the pharmacist in prevention and treatment, as well as in health education, alerting parents to the possible consequences of the evolution of this type of pneumonia.
Pneumonia is an infection of the lower respiratory tract that can be caused by pathogenic agents, such as fungi, viruses or bacterias. Anually, it affects millions of people in the world and has a higher prevalence and mortality rate in underdeveloped regions, namely, Sub-Saharan Africa and Southeast Asia. Community-acquired pneumonia is one of the most common types of pneumonia. It develops in the community or up to 48 hours after admission to a hospital, considering the patient who doesn’t live in nursing homes or other equivalent institutions. This pathology is considered one of the main causes of pediatric morbidity and mortality, however, there has been considerable improvement over the years in this clinical picture. Depending on the medical decision, the treatment can be carried out either in an outpatient or in-patient setting. In community-acquired pneumonia, viral, bacterial and atypical pneumonia stand out and, depending on the etiologic agent, there are several therapeutic options. If viral pneumonia is suspected, antivirals can be instituted. If bacterial etiology is suspected, empirical antibiotic therapy is started, with amoxicillin as the first line. If, after checking the patient's age and analyzing other factors, there is a suspicion that it is an atypical etiological agent, macrolides are prescribed as the first line of treatment. Almost all deaths associated with this infection, especially up to 5 years of age, can be avoided by implementing various prevention strategies. It is essential to reduce risk factors so there is a decrease in morbidity and mortality associated with this disease. In this context, this dissertation work aimed to approach the therapy currently implemented in community-acquired pneumonia in pediatric age, highlighting the fundamental role of the pharmacist in prevention and treatment, as well as in health education, alerting parents to the possible consequences of the evolution of this type of pneumonia.
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Keywords
Pneumonia adquirida na comunidade Idade pediátrica Terapêutica Prevenção Papel do farmacêutico