Management of Pneumonia in the Nursing Home

Pneumonia is a major cause of morbidity and mortality among nursing home residents The approach to managing these patients has lacked uniformity because of the paucity of clinical trials, complexity of underlying comorbid diseases, and heterogeneity of administrative structures The decision to hospitalize nursing home patients with pneumonia vanes among institutions depending on staffing level, availability of diagnostic testing, and laboratory support In the absence of comparative studies, choice of empirical antibiotic therapy continues to be based on expert opinion Validated prognostic scoring models are needed for risk stratification Pneumococcal and influenza vaccination are the primary prevention measures As of January 2010, Medicare no longer pays for consultation codes, thus, practitioners must instead use existing evaluation and management service codes when providing these services CHEST 2010, 138(6) 1480-1485