What is CABP?
CABP is a medical term for Community Acquired Bacterial Pneumonia, an infection in the lung(s) most commonly caused by bacteria, though it can also result from viruses or fungi. Five million Americans annually develop pneumonia, and it is the leading cause of infection-related death and hospitalization in the U.S.
When the lung becomes infected, it typically causes inflammation and mucus production. People who develop bacterial pneumonia usually have a cough, high fever, chills/sweats, trouble breathing, chest discomfort, fatigue, and body aches. As physicians, we recognize people with pneumonia by the symptoms they are reporting along with evaluating heart rate, breathing rate, what the lungs sound like using a stethoscope, lung appearance on a chest x-ray, and oxygen levels in the blood.
People over the age of 70, especially those with chronic medical conditions such as heart disease, lung disease and weakened immune systems, are affected more often than those who are younger. Higher rates of complications such as needing to be placed on oxygen and possibly on a breathing machine can be seen in the older group. Older patients have a greater risk of developing sepsis, organ failure, and possible death from pneumonia.
How is CABP treated?
Pneumonia is typically treated with antibiotics that may be given by mouth or through an intravenous catheter. Various antibiotics can be used. Recent new national pneumonia treatment guidelines were published. Clinicians can use these guidelines to help select the most appropriate antibiotic to use.
Staying hydrated can be helpful as long as there are no chronic heart, kidney, or other conditions that make someone prone to fluid overload. Adults can take ibuprofen (Motrin), acetaminophen (Tylenol), or aspirin to treat fever along with aches and pain. Getting good rest is important to treatment and recovery.
Pneumonia and influenza vaccination is an important first step older patients and young children can take to help prevent pneumonia. Washing hands often and covering one’s mouth when coughing can help prevent the spread of bacteria to others. Taking care of oneself, getting good sleep, regular exercise, not smoking and eating healthy can help prevent against developing pneumonia.
How can I learn more?
There are reliable online resources available to learn more about pneumonia. The American Lung Association and the Centers for Disease Control and Prevention (CDC) have very good resources published for patients searching on the web for more information. Ideally someone who is developing possible signs and symptoms of pneumonia, or someone seeking preventative care, should see their primary care physician.
Your insurance company may have a nurse communication line you can call for further information. When a primary care physician is not available, consider going to an urgent care or Emergency Department. Those who have significant trouble breathing and/or are not acting like they normally do should call 911 and go to an emergency department for further evaluation.
Patients with pneumonia in the St. Louis region previously participated in a clinical trial evaluating a new antibiotic to treat community acquired bacterial pneumonia. This new antibiotic, called Xenleta (lefamulin) was recently approved by the FDA to use in patients to treat community acquired bacterial pneumonia. Xenleta is the first novel antibiotic approved by the FDA in nearly 20 years to treat community acquired bacterial pneumonia. Antibiotic resistance to bacteria causing pneumonia is becoming a serious threat worldwide including in the U.S. as recently reported by the CDC. The St. Louis region should be proud of their participation in the clinical trial that led to FDA approval of this new antibiotic. Xenleta has a low rate of resistance and no cross resistance with antibiotic classes commonly used today to treat community acquired bacterial pneumonia. Having more antibiotic options available and effective against bacterial pneumonia as resistance to commonly used antibiotics grows remains important to maintaining the health of society as well as reducing the complication and death rate from pneumonia.
Robert Poirier, M.D., is a medical expert in the Department of Emergency Medicine at Washington University School of Medicine.