ĐiỀU TRỊ VIÊM PHỔI CỘNG ĐỒNG
VÀ VIÊM PHỔI BỆNH ViỆN
PGS.TS. Trần Văn Ngọc
NỘI DUNG
 Đề kháng kháng sinh :
 Viêm phổi cộng đồng
 Viêm phổi bệnh viện

 Điều tri viêm phổi
 Viêm phổi cộng đồng
 Viêm phổi bệnh viện
VPCĐ
 Nguyên nhân chết hàng thứ 6 tại Mỹ
 2-3 triệu ca / năm
 500,000 nhập viện / năm
 45,000 chết / năm
 Tỉ lệ tử vong
 Ngọai trú < 1%
 Nội trú 10%-14%
 ICU 30%-40%
Bartlett JG et al. Clin Infect Dis. 2000;31:347-382.
 Tử vong do VPCĐ không giảm từ khi
Penicilline được sử dụng đến nay.
 Tỉ lệ tử vong đối với bệnh nhân ngọai trú < 1%
 Bệnh nhân nội trú khoảng 10%-14%
 Bệnh nhân nhập ICU từ 30%-40%.

 Việt Nam: VPCĐ nguyên nhân thường gặp
nhất trong các bệnh nhiễm trùng.

Region 2
Region 3
Region 4
Atypical Incidence:
22%
Atypical Incidence:
28%
Atypical Incidence:
21%
Atypical Incidence:
20%
Atypical Therapy: 91%
Atypical Therapy: 74%
Atypical Therapy: 53%
Atypical Therapy: 10%
THE CAPO PROJECT
Đề kháng kháng sinh trong
viêm phổi cộng đồng

- S.pneumoniae kháng PNC, macrolide và quinolone
- H.influenzae và M.catarrhalis sinh betalactamase
- CAP-MRSA
- Vi khuẩn không điển hình
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