Materiały źródłowe

• #1 Pneumonia – Prevention | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/pneumonia/prevention

  Pneumonia can be very serious and even life-threatening. You can take a few steps to try and prevent it. […] Vaccines can help prevent some types of pneumonia. Good hygiene (washing your hands often), quitting smoking, and keeping your immune system strong by getting regular physical activity and eating healthy are other ways to lower your risk of getting pneumonia. […] Vaccines can help prevent pneumonia caused by pneumococcus bacteria or the flu virus. […] Two vaccines are available to prevent infections from the pneumococcus bacteria, the most common type of bacteria that causes pneumonia. […] Pneumococcus vaccines are especially important for people at high risk of pneumonia, including: Adults age 65 or older, Children age 2 or younger, People who have chronic (ongoing) diseases, serious long-term health problems, or weak immune systems.

• #1 Pneumonia – Prevention | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/pneumonia/prevention

  Your yearly flu vaccine can help prevent pneumonia caused by the flu. […] The Hib vaccine is recommended for all children under 5 years old in the United States. […] You can take the following steps to help prevent pneumonia: Wash your hands with soap and water or alcohol-based hand sanitizers to kill germs. […] Dont smoke. Smoking prevents your lungs from properly filtering out and defending your body against germs. […] Keep your immune system strong. Get plenty of physical activity and follow a healthy eating plan. […] If your immune system is impaired or weakened, your provider may recommend you take antibiotics to prevent bacteria from growing in your lungs.

• #1 Pneumonia

  https://www.nhs.uk/conditions/pneumonia/

  There are several vaccines available to help protect you or your child from infections that can cause pneumonia: […] pneumococcal vaccine recommended for babies, adults over 65 and people at higher risk of pneumococcal infections […] flu vaccine recommended during pregnancy, for adults over 65, people with certain long-term health conditions and those at high risk of catching or passing on flu […] RSV vaccine recommended for adults aged 75 to 79, and during pregnancy (from 28 weeks onwards) to help protect your baby after they’re born […] COVID-19 vaccine a seasonal vaccine that’s recommended for people at increased risk from COVID-19. […] Stopping smoking also reduces your chance of getting pneumonia.

• #1 Preventing Pneumonia | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/preventing-pneumonia

  Yes, many cases can be prevented. You can reduce your risk of getting pneumonia by following a few simple steps. Here’s how: […] Being up to date on your recommended vaccines like an annual flu shot can help prevent pneumonia. […] Certain people should get vaccinated against pneumococcal pneumonia, a common form of bacterial pneumonia including: All children younger than 5 years old. […] Additional pneumococcal vaccinations may be recommended for children and adults who are at increased risk of pneumococcal disease depending on their health condition(s). […] There are several other vaccines that can help prevent infections by bacteria and viruses that may lead to pneumonia, including pertussis (whooping cough), chicken pox, Haemophilus influenzae type b (Hib), and measles. […] Tobacco damages your lung’s ability to fight off infection, and people who smoke have been found to be at higher risk of getting pneumonia.

• #1

  https://www.healthxchange.sg/heart-lungs/lung-conditions/pneumonia-treatment-prevention

  Pneumonia: Treatment and Prevention […] How to prevent pneumonia […] Practice good hygiene and wash hands frequently and thoroughly. […] Avoid contact with live animals including poultry and birds, and consumption of raw and undercooked meats. […] Avoid close contact with people who are unwell or showing symptoms of illness. […] Observe good personal hygiene. […] Practise frequent hand washing with soap (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretions after coughing or sneezing). […] Wear a mask if you have respiratory symptoms such as a cough or runny nose. […] Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately. […] Seek medical attention promptly if you are feeling unwell.

• #1 Pneumonia Prevention and Control | Pneumonia | CDC

  https://www.cdc.gov/pneumonia/prevention/index.html

  Pneumonia can often be prevented and can usually be treated. […] You can lower your risk of pneumonia with immunizations and other healthy living practices. […] Immunizations and appropriate treatment (like antibiotics and antivirals) could prevent many deaths from pneumonia each year. […] Vaccines can help prevent infection by some of the bacteria that can cause pneumonia. […] Vaccines, antibody products, or both can help prevent infection by some of the viruses that can cause pneumonia. […] Avoid people who are sick. If you are sick, stay away from others as much as possible to keep from getting them sick. […] You can also help prevent respiratory infections by washing your hands regularly, cleaning and disinfecting surfaces that are touched a lot, coughing or sneezing into a tissue or into your elbow or sleeve, limiting contact with cigarette smoke or quitting smoking, and taking good care of chronic medical conditions (like asthma).

• #1 Community-acquired pneumonia in adults (non COVID-19) – Prevention | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000108/prevention

  Pneumonia prevention is focused on the pathogens that cause disease, through vaccination and by managing the risks associated with disease development. […] The main means of prevention are pneumococcal and influenza vaccination of at-risk people and smoking cessation. […] At-risk patients should be offered pneumococcal immunisation at every opportunity (for example, when immunising against influenza or at routine consultations), and especially at discharge from hospital. […] Adults aged 65 or over, and at-risk groups: annual influenza vaccine provided they do not have a contraindication. […] Smoking cessation is important for all patients, but particularly for those at risk of pneumonia and influenza. […] Cigarette smoking, both active and passive, is a recognised independent risk factor for CAP. […] For all patients with CAP who smoke, offer advice according to national smoking cessation guidelines.

• #1 Battling Pneumonia: Strategies for Prevention and Recovery

  https://www.fccmg.com/blog/battling-pneumonia-strategies-for-prevention-and-recovery

  Smoking irritates and damages the lungs, making them more susceptible to infection. Quitting smoking is the most critical step you can take to improve your lung health and reduce your risk of pneumonia. […] Eating a balanced diet rich in fruits, vegetables, and whole grains gives your body the essential nutrients it needs to fight infections. […] Regular physical activity strengthens your immune system and overall health. […] Adequate sleep is crucial for a healthy immune system. […] Even after recovering from pneumonia, it’s important to prevent future infections. […] Stay up-to-date on your pneumococcal and flu vaccinations to bolster your immune defenses. […] Regular exercise, a healthy diet, and avoiding smoking are crucial for maintaining healthy lungs.

• #1 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics/print

  Patient education: Pneumonia prevention in adults (Beyond the Basics) […] Pneumonia is a common illness that can be serious or even life-threatening. Not all cases of pneumonia can be prevented but taking certain measures can help. To help prevent pneumonia, you should: […] Get vaccinated […] Stop smoking […] Do not drink too much alcohol […] Lead a healthy lifestyle, including eating a healthy diet and getting regular physical activity […] Control other medical conditions, such as diabetes, if you have them […] When appropriate, getting vaccinated and encouraging others around you to do the same are the best ways to prevent pneumonia. […] Vaccination is particularly important for adults age 65 years or older, as well as any adults who smoke, have a weakened immune system, or have certain chronic illnesses that will predispose to serious illness if they should happen to develop pneumococcal pneumonia.

• #1 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics/print

  In general, experts suggest vaccination for: […] All adults 50 years and older […] Adults (over the age of 18 years) with any of the following: […] Smoking […] Chronic heart disease, including congestive heart failure and cardiomyopathy (but not including high blood pressure) […] Chronic lung disease, including asthma and chronic obstructive pulmonary disease (COPD) […] Diabetes mellitus (unless very well-controlled) […] Alcohol use disorder […] Chronic liver disease […] Chronic kidney disease […] Cerebrospinal fluid leak […] Cochlear implant […] Poor function of the spleen (this includes people who have had their spleen removed and those with sickle cell disease or another disorder that causes spleen damage) […] A weakened immune system, for example, due to certain cancers, human immunodeficiency virus (HIV) infection, organ transplant, or medications that suppress the immune system

• #1 Healthcare-Associated Pneumonia Prevention Guideline | Infection Control | CDC

  https://www.cdc.gov/infection-control/hcp/pneumonia-prevention/index.html

  These guidelines provide recommendations for the prevention of health care-associated pneumonia from CDC and the Healthcare Infection Control Practices Advisory Committee. […] CDC provides information on infection control and clinical safety to help reduce the risk of infections among healthcare workers, patients, and visitors.

• #1 Recommendations for The Prevention of Ventilator-Associated Pneumonia – ISID

  https://isid.org/guide/hospital/recommendations-for-the-prevention-of-ventilator-associated-pneumonia/

  Consequently, there is a need to assess strategies to address this critical situation, particularly in LMICs. […] VAPs have a significant impact on healthcare, leading to increased mortality rates. […] Studies have documented that VAP is an independent significant risk factor for mortality. […] Several authors identified the following as VAP risk factor (RF): Tracheostomy, length of stay (LOS), older age, trauma patients, post-surgical patients, burns patients, longer duration of surgery, history of smoking, low serum albumin concentration, high score on the American Society of Anesthesiologists Physical Status Classification System, APACHE II score 20, acute respiratory distress syndrome, lung injury, chronic obstructive pulmonary disease, upper respiratory tract colonization, sinusitis, PaO2/FiO2 ratio 200mmHg, oropharyngeal colonization, biofilm on the surface and within lumen of the endotracheal tube, duration of mechanical ventilator (MV), frequent change in ventilator circuit, lack of use of heat and moist exchange humidifiers, supine position, frequent reintubation, enteral feeding, multiple central venous line insertions, presence of catheter-related infection, paralytic agents, previous use of broad-spectrum antibiotics, and patients transported out of ICU.

• #1 Recommendations for The Prevention of Ventilator-Associated Pneumonia – ISID

  https://isid.org/guide/hospital/recommendations-for-the-prevention-of-ventilator-associated-pneumonia/

  Avoid intubation and prevent reintubation. […] Minimize sedation. […] Maintain and improve physical conditioning. […] Elevate the head of the bed to 30-45 degrees. […] Provide oral care with toothbrushing but without chlorhexidine. […] Provide early enteral vs. parenteral nutrition. […] Change the ventilator circuit only if visibly soiled or malfunctioning (or per manufacturers instructions). […] Other supplementary interventions encompass interventions linked with reduced rates of VAP, shortened periods of MV ventilation, reduced LOS, and/or decreased mortality, albeit with associated risks. […] It was observed that there is a lack of sufficient education; therefore, an effort should be made to reverse it. […] The empirical evidence delineated in this review incontrovertibly establishes that VAP rates in LMICs persist at a magnitude exceeding tenfold that observed in high-income countries.

• #1 Recommendations for The Prevention of Ventilator-Associated Pneumonia – ISID

  https://isid.org/guide/hospital/recommendations-for-the-prevention-of-ventilator-associated-pneumonia/

  Establishments implementing VAP surveillance and prevention should possess the following components: Assets for delivering suitable education and training. […] Numerous national, multinational, and multicontinental studies, employing a multidimensional approach, have been conducted, achieving a significant reduction in rates of VAP and mortality. […] Care bundles in infection prevention and safety are simple sets of evidence-based practices that, when implemented collectively, improve the reliability of their delivery and improve patient outcomes. […] The INICC utilizes a bundle as part of its approach to reducing VAP rates and was effective in Africa, Asia, Latin America, Eastern Europe, and the Middle East, resulting in a VAP rate reduction. […] Education HCPs, patients, and caregivers participating in the care of a MV should receive training and demonstrate competence, commensurate with their roles, in understanding the recommendations to prevent VAP.

• #1

  https://link.springer.com/article/10.1007/BF01752973

  Nosocomial pneumonias, especially in ventilated patients, are a continuing problem in modern medicine. Several prevention measures for nosocomial pneumonia are possible such as parenteral and topical antibioticsa very controversial issue. Several studies with parenteral antibiotics, starting as early as 1954, could not prove any benefit of parenteral antibiotics in pneumonia prevention. […] However, the combined, approach (SDD) of oropharyngeal, gastrointestinal and parenteral use of certain antibiotics appears to give promising results in specific patient subgroups such as ventilated polytrauma patients in ICU. […] Johanson WG, Seidenfeld JJ, de los Santos R, Coalson JJ, Gomez P (1988) Prevention of nosocomial pneumonia using topical and parenteral antimicrobial agents. Am Rev Respir Dis 137:265269.

• #1 Diffusion Marketplace

  https://marketplace.va.gov/innovations/project-happen

  HAPPEN, or Hospital Acquired Pneumonia Prevention by Engaging Nurses supports VHA priorities by reducing the risk of non-ventilator associated hospital acquired pneumonia (NV-HAP), improving the health and quality of life of our Veterans; modernizing systems and processes with a focus on preventive care; improving access and timeliness of service by reducing patient length of stays; and reducing health care cost. […] Non-ventilator associated hospital acquired pneumonia (NV-HAP) is a preventable complication associated with increased morbidity and mortality, greater need for long-term care after discharge, 4 times longer length of stay, and high healthcare costs ($58,000 median direct care costs per case among Veterans). […] All Veterans are at risk, so prevention measures like oral care are essential.

• #1 Diffusion Marketplace

  https://marketplace.va.gov/innovations/project-happen

  HAPPEN is an oral care initiative that targets the source of NV-HAP- the patient’s own mouth. […] With consistent oral care, the number of the bacteria in the mouth is reduced. […] All Veterans should be offered assistance with their oral care a minimum of twice daily (e.g. toothbrushing) during their hospital or CLC stay. […] HAPPEN implementing sites are reporting declines in NV-HAP of 40-60% thus saving lives, shortening length of stay, reducing the need for long-term care, and improving patient safety and quality of life. […] With consistent oral care, the risk of hospital acquired pneumonia among non-ventilated patients is decreased an average of 40-60%. […] This video is a reminder for direct care staff about the importance of consistent oral hygiene in prevention of hospital acquired pneumonia.

• #1 Preventing pneumonia after surgery | Vancouver Coastal Health

  https://www.vch.ca/en/preventing-pneumonia-after-surgery

  Anytime you are in the hospital, your lungs need help to prevent pneumonia. pneumonia is a potentially life threatening condition and can cause serious complications. […] These simple activities, including early and frequent mobilization, lung exercises, oral hygiene and education will help prevent you from developing lung complications, such as pneumonia, while you are in the hospital. […] Brushing your mouth (teeth, gums and tongue) decreases the amount of germs in your mouth which could move down into your lungs and cause pneumonia. […] Good pain relief is necessary for you to perform the activities described in this pamphlet. Being unable to take a deep breath increases your risk of getting pneumonia.

• #1 Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/10/633

  Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) cause significant inpatient morbidity and mortality. […] The authors describe the diagnosis, management, and prevention of these diseases based on current guidelines and recent evidence. […] Nursing care bundles addressing aspiration risk factors can reduce the incidence of HAP and VAP in the hospital. […] Preventing HAP and VAP is as important as diagnosing and managing them and depends upon multiple approaches to address individual aspiration risk factors and nosocomial transmission of disease. […] Regular oral care, assessment of the need for proton-pump inhibitor and histamine-2-receptor blocker therapy, and early identification and treatment of dysphagia especially in the elderly and in patients with recent stroke or surgical procedures are key features to preventing oropharyngeal colonization of pathogenic organisms, aspiration, and ensuing HAP or VAP.

• #1 American Thoracic Society | Urgent Need for Increased Global Access…

  https://site.thoracic.org/about-us/news/urgent-need-for-increased-global-access-to-effective-prevention-and-treatment-of-pneumonia

  Pneumonia is the leading cause of death in young children. Over 650,000 children under 5 die from pneumonia each year – especially in low- and middle-income countries (LMICs). Pneumonia can be prevented and treated. […] There are several effective preventive strategies for pneumonia, including: good nutrition, prevention of HIV, hand washing, reducing exposure to indoor and outdoor air pollution, and effective vaccines. […] Treating pneumonia requires access to effective antibiotics and oxygen, but this too is still suboptimal in many LMICs. […] On World Pneumonia Day, FIRS calls on governments and other stakeholders to take urgent action to tackle pneumonia by: […] Ensuring that all children and vulnerable adults receive effective pneumonia vaccines. […] Reducing air pollution and exposure to air pollutants and promoting good nutrition, hygiene practices, and smoking cessation to reduce the risk of pneumonia.

• #1 Pneumonia: Symptoms, Diagnosis, Treatment and Prevention | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/pneumonia

• #1

  https://www.who.int/health-topics/pneumonia

  Pneumonia can be prevented by vaccines. […] People of all ages can reduce their risk of pneumonia by: […] Get vaccinated: Immunization against Hib, pneumococcus, measles, influenza and whooping cough (pertussis) is the most effective way to prevent pneumonia. […] Wash your hands: Maintain good hygiene and washing your hands frequently, especially when caring for others who are sick or after blowing your nose, will keep germs from spreading. […] Address environmental factors: Reduce indoor air pollution by providing affordable clean indoor stoves and stop smoking. […] Maintain healthy lifestyle: Eat a healthy diet, rest and get regular exercise to help you stay well. […] Adequate nutrition is key to improving natural defences, starting with exclusive breastfeeding for the first 6 months of life.

• #1 Pneumonia Prevention and How to Care for Your Child – PSRI Hospital

  https://psrihospital.com/pneumonia-prevention-and-how-to-care-for-your-child/

  Do you know that in India, pneumonia accounts for 14% of all deaths of children under five years old? […] Therefore, parents need to understand how to prevent and care for their children if they are diagnosed with pneumonia. […] Immunisation, good nutrition, and changing environmental factors can all help to prevent pneumonia. […] Vaccines are available to protect against some of the most standard types of bacterial pneumonia in children. […] It is important to practise good hygiene, such as washing hands regularly, to take preventive measures of pneumonia. […] If children who are undernourished or have vitamin A deficiency, their parents need to take preventive measures of pneumonia. […] Make sure that your child is immunised (vaccinated). The Hib and Pneumococcal vaccines (PVC13) will help rescue your child against bacterial issues of pneumonia.

• #1 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics

  Patient education: Pneumonia prevention in adults (Beyond the Basics) […] To help prevent pneumonia, you should: […] Get vaccinated […] Stop smoking […] Do not drink too much alcohol […] Lead a healthy lifestyle, including eating a healthy diet and getting regular physical activity […] Control other medical conditions, such as diabetes, if you have them […] Vaccination is particularly important for adults age 65 years or older, as well as any adults who smoke, have a weakened immune system, or have certain chronic illnesses that will predispose to serious illness if they should happen to develop pneumococcal pneumonia. […] In general, experts suggest vaccination for: […] All adults 50 years and older […] Adults (over the age of 18 years) with any of the following: […] Smoking

• #1 Seniors, Pneumonia Prevention and Care | Lifeline

  https://www.lifeline.com/blog/seniors-pneumonia-prevention-and-care/

  Senior citizens are more likely to get pneumonia and suffer its severe complications due to the changes that come with aging. […] The most reliable way to prevent pneumonia in the elderly is to get the pneumococcal and influenza vaccine. The pneumococcal vaccine protects you against 23 strains of pneumococcus bacteria. […] Smoking destroys the lungs and makes them more prone to infections. Dropping the vice can help prevent pneumonia. […] Washing hands regularly will help you avoid contracting or transmitting the disease to other people. This is virtually true for caregivers looking after the elderly. You also need to clean and disinfect surfaces in the bathroom and kitchens. […] Staying physically active, eating healthy foods, taking plenty of fluids, and having an adequate sleep can help your stay healthy. It will also improve your immune system to fight all kinds of illnesses.

• #1 Pneumonia Guide for Seniors: Recovery & Prevention Tips

  https://floridaseniorconsulting.com/pneumonia-guide-for-seniors/

  Get the pneumococcal vaccine: There are two pneumococcal vaccines available for adults ages 65 years and older – ask your doctor which one is recommended for you. If you have a weakened immune system or certain chronic health conditions, you may qualify for a pneumococcal vaccine before age 65. […] Get your flu shot every year: The flu is one of the most common causes of pneumonia, so staying up to date on your annual vaccines is crucial for prevention. […] Stop smoking cigarettes: Smoking damages the lungs and weakens the immune system, making it harder for your body to fight off a respiratory infection. […] Make healthy lifestyle choices: Regular exercise, a balanced diet, hydration, and sufficient sleep are key to preventing illnesses and keeping your immune system strong, helping you fight off infection more easily. […] By following key prevention strategies—such as getting vaccinated, maintaining good hygiene, and making healthy lifestyle choices—seniors can significantly reduce their risk of contracting pneumonia.

• #1 Battling Pneumonia: Strategies for Prevention and Recovery

  https://www.fccmg.com/blog/battling-pneumonia-strategies-for-prevention-and-recovery

  Pneumonia is a serious infection that inflames the air sacs in the lungs, making breathing difficult. […] The good news is that with proper preventative measures and early intervention, you can significantly reduce your chances of contracting pneumonia and promote a healthy recovery if you do get it. […] Here are some key pneumonia prevention tips […] This vaccine protects against several strains of bacteria that commonly cause pneumococcal pneumonia. […] The influenza virus can sometimes progress to pneumonia. Getting an annual flu shot is one of the most effective ways to protect yourself from the flu and its potential complications. […] Frequent handwashing with soap and water is one of the best defenses against many illnesses, including pneumonia. […] Chronic obstructive pulmonary disease (COPD), asthma, and heart disease can increase the risk of developing pneumonia.

• #1 Pneumocystis Pneumonia: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/pneumocystis

  Pneumocystis pneumonia (PCP) is caused by Pneumocystis jirovecii, a ubiquitous fungus. […] Before the widespread use of PCP prophylaxis and antiretroviral therapy (ART), PCP occurred in 70% to 80% of people with advanced HIV, with a 20% to 40% mortality rate in individuals despite anti-Pneumocystis therapy. […] The incidence of PCP has declined substantially with widespread use of PCP prophylaxis and ART; incidence among people with HIV in Western Europe and the United States is 1 case per 100 person-years. […] There are insufficient data to support isolation as standard practice to prevent PCP. […] Recommendations for Preventing First Episode of Pneumocystis Pneumonia (Primary Prophylaxis) […] Indications for Initiating Primary Prophylaxis […] CD4 count 100200 cells/mm3, if plasma HIV RNA level above detection limits, or

• #1 Prophylaxis – Pneumocystis jirovecii (carinii) pneumonia in cancer patients

  https://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/prophylaxis-and-treatment/220-pneumocystis-jirovecii-pneumonia-pjp-prophyl

  PJP is associated with high morbidity and mortality rates in patients (30-60%) following treatment for haematological malignancies or after haematopoietic stem cell transplant (HSCT). […] Appropriate and adequate prophylaxis for all moderate- to high-risk patients is a key strategy for improving outcomes as most cases of PJP occur in patients either not receiving adequate prophylaxis or not complying with their prescribed prophylaxis. […] In a meta-analysis of randomized trials of PJP prophylaxis in immunocompromised patients without HIV infection, it was concluded that, in adults, prophylaxis is warranted when the risk of PJP is higher than 3.5%. […] Prophylaxis is recommended in B-cell ALL (acute lymphoblastic leukaemia). […] Prophylaxis in lymphoma will depend on risk factors for PJP. […] Consider prophylaxis during neutropenia. […] Consider prophylaxis if high-dose steroids are used (>= 20 mg prednisolone daily for 4 or more weeks). […] Prophylaxis is generally not required.

• #1 Pneumocystis Pneumonia: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/pneumocystis

  CD4 count 100 cells/mm3, regardless of plasma HIV RNA level. […] Preferred Therapy […] TMP-SMX, 1 DS tablet PO daily, or […] TMP-SMX, 1 SS tablet PO daily. […] Indication for Discontinuing Primary Prophylaxis […] CD4 count increased from 200 cells/mm3 to 200 cells/mm3 for 3 months in response to ART. […] Indication for Restarting Primary Prophylaxis […] CD4 count 100 cells/mm3 regardless of HIV RNA. […] TMP-SMX is the recommended prophylactic agent for PCP. […] TMP-SMX chemoprophylaxis should be continued, when clinically feasible, in people with HIV who have non-life threatening adverse reactions. […] For people with HIV who develop PCP despite TMP-SMX prophylaxis usually can be treated effectively with standard doses of TMP-SMX. […] If not already started, ART should be initiated in patients within 2 weeks of diagnosis of PCP, if possible.

• #1 Pneumocystis jirovecii pneumonia prophylaxis in PWH – SHEA

  https://shea-online.org/shea-journal-club/june-2024/pneumocystis-jirovecii-pneumonia-prophylaxis-in-pwh/

  A network meta-analysis concludes that TMP-SMX remains the most effective agent for PJP prophylaxis in PWH and is the only agent associated with PJP-related & all-cause mortality benefit. […] Prophylactic regimens include trimethoprim-sulfamethoxazole (TMP-SMX), dapsone-based regimens (DBRs), atovaquone, and aerosolized pentamidine (AP). […] The authors found that TMP-SMX is the most effective agent for PJP prophylaxis in PWH and is the only agent to confer a mortality benefit compared with no treatment/placebo but has a higher risk of discontinuation due to adverse events. […] In conclusion, TMP-SMX should continue to be recommended as the first-line agent for prophylaxis among PJP.

• #1 Pneumonia – Symptoms, Causes, Treatment, Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number for ap

  https://www.pacehospital.com/pneumonia-causes-symptoms-types-treatment-prevention

  Strengthen the immune system: Eating a balanced diet, exercising regularly, and getting enough sleep can strengthen the immune system and reduce susceptibility to infections. […] Avoiding crowded places: Crowding is an essential risk factor for various infectious diseases, making it easier to spread infections like pneumonia. Hence, encouraging young children and persons who are at high risk of pneumonia to avoid crowded places can help reduce the number of people who fall ill with pneumonia. […] Avoiding aspiration: For individuals at risk of aspiration, such as those with swallowing difficulties, it is important to be cautious about food and drink intake to prevent food or liquids from entering the lungs. […] Addressing environmental factors: Avoiding certain environmental factors, such as indoor air pollution and lung irritants like smoking (quitting smoking), can help reduce pneumonia risk. […] Treating the chronic conditions: Managing chronic diseases, especially in older patients, including diabetes, asthma, and heart conditions, can reduce the risk of pneumonia by preventing complications and improving overall health.

• #1

  https://www.who.int/publications/i/item/the-integrated-global-action-plan-for-prevention-and-control-of-pneumonia-and-diarrhoea-(gappd)

  The integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) proposes a cohesive approach to ending preventable pneumonia and diarrhoea deaths. […] Reaching every child will require the scaling up and targeting of interventions known to prevent and control pneumonia and diarrhoea. […] Parents, communities, community health workers (CHWs), civil society and the private sector all have significant roles in enabling this vision.

• #1 Pneumonia can occur across life’s stages—prevention should too | PATH

  https://www.path.org/our-impact/articles/pneumonia-can-occur-across-lifes-stagesprevention-should-too/

  Most vaccination programs focus on discrete life stages, such as childhood, but this can mean that other at-risk stages fall through the cracks. […] Many experts believe that this approach is key for preventing pneumonia. […] A goal and best practice named in the Immunization Agenda 2030, life-course vaccination is a way to add more layers of defense, including against pneumonia, adds Dr. Innis. […] Life-course vaccination is a way to add more layers of defense, including against pneumonia. […] In addition to preventing disease in young infants, maternal immunization is also a robust tool for preventing respiratory infections with heightened risks during pregnancy, like COVID-19. […] The pandemic has highlighted how factors like pregnancy status can drive vaccine inequity. […] In a life-course approach, childhood vaccination is a cornerstone, including for pneumococcusa top cause of deadly pediatric pneumonia as well as meningitis, sepsis, and debilitating middle ear infections.

• #1 Urgent Need for Increased Global Access to Effective Prevention and Treatment of Pneumonia – ERS – European Respiratory Society

  https://www.ersnet.org/news-and-features/news/urgent-need-for-increased-global-access-to-effective-prevention-and-treatment-of-pneumonia/

  Strengthening health systems capacity. […] Ensuring that all children and vulnerable adults receive effective pneumonia vaccines. […] Reducing air pollution and exposure to air pollutants and promoting good nutrition, hygiene practices, and smoking cessation to reduce the risk of pneumonia. […] Raising awareness and knowledge about pneumonia prevention and treatment. […] Improving access to antibiotics, pulse oximetry and oxygen therapy. […] Encouraging funders to invest in pneumonia research and services and supporting research to implement pneumonia prevention and treatment interventions. […] Strengthening preventive and treatment interventions to ensure everyone has access to these effective interventions is crucial to reduce deaths and illness from pneumonia. New vaccines must be available and affordable globally.

• #2 Pneumonia Prevention and Control | Pneumonia | CDC

  https://www.cdc.gov/pneumonia/prevention/index.html

  Pneumonia can often be prevented and can usually be treated. […] You can lower your risk of pneumonia with immunizations and other healthy living practices. […] Immunizations and appropriate treatment (like antibiotics and antivirals) could prevent many deaths from pneumonia each year. […] Vaccines can help prevent infection by some of the bacteria that can cause pneumonia. […] Vaccines, antibody products, or both can help prevent infection by some of the viruses that can cause pneumonia. […] Avoid people who are sick. If you are sick, stay away from others as much as possible to keep from getting them sick. […] You can also help prevent respiratory infections by washing your hands regularly, cleaning and disinfecting surfaces that are touched a lot, coughing or sneezing into a tissue or into your elbow or sleeve, limiting contact with cigarette smoke or quitting smoking, and taking good care of chronic medical conditions (like asthma).

• #2 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics/print

  Patient education: Pneumonia prevention in adults (Beyond the Basics) […] Pneumonia is a common illness that can be serious or even life-threatening. Not all cases of pneumonia can be prevented but taking certain measures can help. To help prevent pneumonia, you should: […] Get vaccinated […] Stop smoking […] Do not drink too much alcohol […] Lead a healthy lifestyle, including eating a healthy diet and getting regular physical activity […] Control other medical conditions, such as diabetes, if you have them […] When appropriate, getting vaccinated and encouraging others around you to do the same are the best ways to prevent pneumonia. […] Vaccination is particularly important for adults age 65 years or older, as well as any adults who smoke, have a weakened immune system, or have certain chronic illnesses that will predispose to serious illness if they should happen to develop pneumococcal pneumonia.

• #2 Pneumonia: Diagnosis, Symptoms, and Treatment

  https://www.healthline.com/health/pneumonia

  Pneumonia can often be a complication of the flu, so be sure to also get an annual flu shot. The CDC recommends that everyone ages 6 months and older get vaccinated, particularly those who may be at risk of flu complications. […] The first line of defense against pneumonia is to get vaccinated. There are several vaccines that can help prevent pneumonia. […] According to the National Heart, Lung, and Blood Institute, pneumonia vaccines wont prevent all cases of the condition. But if youre vaccinated, youre likely to have a milder and shorter illness as well as a lower risk of complications. […] In addition to vaccination, there are other things you can do to avoid pneumonia: If you smoke, try to quit. Smoking makes you more susceptible to respiratory infections, especially pneumonia. Regularly wash your hands with soap and water for at least 20 seconds. Cover your coughs and sneezes. Promptly dispose used tissues. Maintain a healthy lifestyle to strengthen your immune system. Get enough rest, eat a balanced diet, and get regular exercise. […] Together with vaccination and additional prevention steps, you can help reduce your risk of getting pneumonia. Here are even more prevention tips.

• #2 Pneumonia: Symptoms, Diagnosis, Treatment and Prevention | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/pneumonia

• #2 FIRS calls for urgent action to expand access to pneumonia prevention and treatment worldwide – ERS – European Respiratory Society

  https://www.ersnet.org/news-and-features/news/firs-calls-for-urgent-action-to-expand-access-to-pneumonia-prevention-and-treatment-worldwide/

  FIRS calls for urgent action to expand access to pneumonia prevention and treatment worldwide […] On World Pneumonia Day, 12 November, 2024, the Forum of International Respiratory Societies (FIRS), of which ERS is a founding member, is calling for urgent action to prevent pneumonia deaths among high-risk groups particularly children younger than five years and older people. New effective preventive interventions are available, but these are still inaccessible in many low and middle-income countries (LMICs). […] New, highly effective interventions to prevent respiratory syncytial virus (RSV) pneumonia in infants and young children have recently become available and can substantially reduce the burden of childhood pneumonia and mortality. However, access and affordability in LMICs is crucial to reduce global inequity and promote health for all children, especially as most severe illness occurs in LMICs.

• #2 How Do You Prevent and Treat Pneumonia? Vaccines, Medications, and More

  https://www.everydayhealth.com/pneumonia/guide/treatment/

  Besides these vaccinations, other steps to protect against pneumonia include: […] Get vaccinated to prevent other infections that may lead to pneumonia, including flu, COVID-19, and (if you are eligible) RSV. […] If you do get sick, take steps to prevent spreading pneumonia. […] Vaccines are a powerful way to prevent pneumonia, but if you get sick, you may experience a relatively mild case that just requires antibiotics or antiviral medication, or a few days of rest.

• #2 Bronchiectasis and Pneumonia tips on prevention | Mayo Clinic Connect

  https://connect.mayoclinic.org/discussion/bronchiectasis-and-pneumonia-tips-on-prevention/

  I try so hard to prevent pneumonia no matter what I do. It keeps coming back year after year. […] Sadly, our respiratory conditions, especially bronchiectasis, make us prone to repeat pneumonias. Off the top of my head, I’d say to be sure to keep up with yearly vaccines, along with others such as the pneumonia vaccine, covid, RSV, shingles etc. […] Masking in high risk areas, I believe, is also important (grocery store, airports/planes, theaters), anywhere where there are a lot of people in a small area. […] Maybe at the top of the list should be consistent daily airway clearance. Many pulmonologists recommend twice daily 7% saline via nebulizer followed by an airway clearance routine, which may include Active Cycle of Breathing and Autogenic Drainage. […] The key is to „catch it” before it progresses to pneumonia. Other prodromes might include fatigue, headache, malaise, lack of appetite, increased coughing, etc.

• #2

  https://www.healthxchange.sg/heart-lungs/lung-conditions/pneumonia-treatment-prevention

  Pneumonia: Treatment and Prevention […] How to prevent pneumonia […] Practice good hygiene and wash hands frequently and thoroughly. […] Avoid contact with live animals including poultry and birds, and consumption of raw and undercooked meats. […] Avoid close contact with people who are unwell or showing symptoms of illness. […] Observe good personal hygiene. […] Practise frequent hand washing with soap (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretions after coughing or sneezing). […] Wear a mask if you have respiratory symptoms such as a cough or runny nose. […] Cover your mouth with a tissue paper when coughing or sneezing, and dispose the soiled tissue paper in the rubbish bin immediately. […] Seek medical attention promptly if you are feeling unwell.

• #2 Pneumonia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4471-pneumonia

  The best way to prevent pneumonia is to get vaccinated against bacteria and viruses that commonly cause it. There are also everyday precautions you can take to help reduce your risk of pneumonia. […] There are two types of vaccines (shots) that prevent pneumonia caused by pneumococcal bacteria. Similar to a flu shot, these vaccines wont protect against all types of pneumonia, but if you do get sick, its less likely to be severe. […] As certain viruses can lead to pneumonia, getting vaccinated against COVID-19 and the flu can help reduce your risk of getting pneumonia. […] In addition to getting vaccinated, you can reduce your risk of getting and spreading pneumonia with some healthy habits: Quit smoking and avoid secondhand smoke. Smoking damages your lungs and makes you more likely to get an infection. […] If you have to stay in a hospital or other healthcare facility, dont be afraid to ask your providers about how to reduce your risk of getting an infection during your stay.

• #2 Pneumocystis jiroveci Pneumonia (PJP): Overview of Pneumocystis jiroveci Pneumonia, Microbiology of Pneumocystis jiroveci Pneumonia, Pathophysiology and Etiology of Pneumocystis jiroveci Pneumonia

  https://emedicine.medscape.com/article/225976-overview

  Pneumocystis jiroveci pneumonia (PJP) is the most common opportunistic infection in persons with HIV infection. […] Preventive measures (eg, smoking cessation and chemoprophylaxis) can play an important role in disease management. […] Smoking cessation is strongly recommended in patients with HIV infection, as studies have shown that, in addition to the common deleterious effects of tobacco use, smokers are at an increased risk of P jiroveci pneumonia (PJP) and have a more complicated treatment course. […] An expert panel overseen by the US Public Health Service and Infectious Disease Society of America has published guidelines on prophylaxis against P jiroveci pneumonia (PJP) in adult and pediatric patients with HIV infection. Chemoprophylaxis is recommended for the following groups:

• #2 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics/print

  Quitting smoking and avoiding secondhand smoke exposure is an important way to help prevent pneumonia and improve your overall health. […] Washing your hands with soap and water or using an alcohol-based hand sanitizer is one of the most important ways to avoid spreading illness to others, particularly when you have a viral infection such as influenza. […] Living a healthy lifestyle including eating right, exercising, and maintaining a healthy weight can help prevent many health problems. Taking medicines as prescribed, particularly for chronic illnesses that increase the risk of pneumonia, can also help prevent health complications. […] Ensuring that you and those around you are up to date on recommended vaccines can help prevent pneumonia in you, your family, and your community.

• #2 Pneumonia – Lung Health Foundation – Prevention

  https://lunghealth.ca/lung-disease/a-to-z/pneumonia/

  If you smoke, try to quit-smoke damages the natural defenses in your lungs (e.g., cilia) that protect you from infections. […] Ask your healthcare provider about getting the pneumococcal vaccination. […] Get the flu vaccination each year-since pneumonia can be a complication of getting the flu, the flu vaccine helps reduce the risk of both the flu and pneumonia. […] Stay away from people who are sick. […] Wash your hands regularly. When soap and water are not available, use a hand sanitizer that contains at least 60% alcohol. […] If you have an underlying condition that increases your risk of pneumonia (e.g., chronic obstructive pulmonary disease, asthma, bronchiectasis, cystic fibrosis), make sure its kept under control. […] If you are at a higher risk from pneumonia and you get a cough, fever or shortness of breath, see your healthcare provider right away. […] Regular exercise, adequate sleep and a healthy diet can strengthen your immune system.

• #2 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics/print

  In general, experts suggest vaccination for: […] All adults 50 years and older […] Adults (over the age of 18 years) with any of the following: […] Smoking […] Chronic heart disease, including congestive heart failure and cardiomyopathy (but not including high blood pressure) […] Chronic lung disease, including asthma and chronic obstructive pulmonary disease (COPD) […] Diabetes mellitus (unless very well-controlled) […] Alcohol use disorder […] Chronic liver disease […] Chronic kidney disease […] Cerebrospinal fluid leak […] Cochlear implant […] Poor function of the spleen (this includes people who have had their spleen removed and those with sickle cell disease or another disorder that causes spleen damage) […] A weakened immune system, for example, due to certain cancers, human immunodeficiency virus (HIV) infection, organ transplant, or medications that suppress the immune system

• #2 Preventing Pneumonia | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/preventing-pneumonia

  Good health habits a healthy diet, rest, regular exercise, etc. help keep you from getting sick from viruses and respiratory illnesses. They also help promote faster recovery when you do get a cold, the flu or other respiratory illness. […] Take care to keep well managed existing health conditions such as asthma, COPD, diabetes and heart disease.

• #2 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics

  Chronic heart disease, including congestive heart failure and cardiomyopathy (but not including high blood pressure) […] Chronic lung disease, including asthma and chronic obstructive pulmonary disease (COPD) […] Diabetes mellitus (unless very well-controlled) […] Alcohol use disorder […] Chronic liver disease […] Chronic kidney disease […] Cerebrospinal fluid leak […] Cochlear implant […] Poor function of the spleen (this includes people who have had their spleen removed and those with sickle cell disease or another disorder that causes spleen damage) […] A weakened immune system, for example, due to certain cancers, human immunodeficiency virus (HIV) infection, organ transplant, or medications that suppress the immune system […] Quitting smoking and avoiding secondhand smoke exposure is an important way to help prevent pneumonia and improve your overall health.

• #2 Recommendations for The Prevention of Ventilator-Associated Pneumonia – ISID

  https://isid.org/guide/hospital/recommendations-for-the-prevention-of-ventilator-associated-pneumonia/

  This document intends to review the available evidence and provide a more international spectrum, including specific recommendations to address situations that are particularly relevant in low- and middle-income countries (LMIC). It highlights practical recommendations in a concise format designed to assist acute-care hospitals in implementing and prioritizing their ventilator-associated pneumonia (VAP) prevention efforts in LMICs as well as in high-income countries. […] Given that the majority of LMICs continue to rely on the criteria and definition of VAP and have yet to adopt the utilization of Ventilator-Associated Events (VAE), our review concentrates on interventions aimed at reducing VAP. […] VAP rates in LMICs exceed those in the USA. The International Nosocomial Infection Control Consortium (INICC) observed consistently higher VAP rates in LMICs over the past two decades.

• #2 Recommendations for The Prevention of Ventilator-Associated Pneumonia – ISID

  https://isid.org/guide/hospital/recommendations-for-the-prevention-of-ventilator-associated-pneumonia/

  Establishments implementing VAP surveillance and prevention should possess the following components: Assets for delivering suitable education and training. […] Numerous national, multinational, and multicontinental studies, employing a multidimensional approach, have been conducted, achieving a significant reduction in rates of VAP and mortality. […] Care bundles in infection prevention and safety are simple sets of evidence-based practices that, when implemented collectively, improve the reliability of their delivery and improve patient outcomes. […] The INICC utilizes a bundle as part of its approach to reducing VAP rates and was effective in Africa, Asia, Latin America, Eastern Europe, and the Middle East, resulting in a VAP rate reduction. […] Education HCPs, patients, and caregivers participating in the care of a MV should receive training and demonstrate competence, commensurate with their roles, in understanding the recommendations to prevent VAP.

• #2 Pneumonia: Etiology, Care and Prevention | RT

  https://respiratory-therapy.com/disorders-diseases/infectious-diseases/other-infections/pneumonia-etiology-care-and-prevention/

  Other practical steps in preventing pneumonia include careful handwashing, cleaning and disinfecting surfaces that may serve as transmission sites, following cough/sneeze etiquette, quitting smoking and avoiding cigarette smoke, and taking steps to manage chronic conditions such as asthma and COPD. […] Recommendations for avoiding HAP/VAP include: Use of high-flow nasal oxygen and/or noninvasive ventilation if appropriate, Avoid intubation and prevent reintubation if possible, Minimize use of sedation and follow a protocol for sedation vacations, Follow a protocol for weaning and discontinuing mechanical ventilation (MV) to minimize time on MV, Elevate the head of the bed 30o to 45o, Provide early exercise and mobilization, Perform oral care with toothbrushing, Provide early enteral nutrition, Only change ventilator circuits if visibly soiled or malfunctioning, Diagnose and manage dysphagia to reduce risk of aspiration, Implement ventilator bundles and pneumonia prevention bundles, Monitor, measure, and report outcomes on incidence of pneumonia, Educate staff on bundles and monitoring results, Incorporate changes to address areas of weakness, lack of compliance.

• #2 Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/10/633

  Data supporting oral care in VAP prevention are more robust, with several institutions worldwide reporting reduced VAP incidence in association with ICU bundles including an oral care component. […] Standardized use of aspiration-prevention strategies and didactic modules, championed by an invested multi-disciplinary team, can collectively reduce aspiration risk and associated pneumonia. […] Timely vaccinations for both patients and providers reliably reduce transmission of influenza, Haemophilus influenzae, and Streptococcus pneumoniae pneumonia. […] Hospital-wide respiratory hygiene measures such as hand hygiene and the use of masks or tissues for patients with a cough can reduce the spread of respiratory pathogens.

• #2 Pneumonia – APIC

  https://apic.org/resources/topic-specific-infection-prevention/pneumonia/

  Pneumonia is an infection of the lungs. This page contains pneumonia prevention resources and education for both healthcare professionals and consumers. […] Strategies to Prevent VentilatorAssociated Pneumonia in Acute Care Hospitals:2014 updateThe Society for Healthcare Epidemiology of America (APIC collaborated with SHEA and other organizations on development of this resource) […] Preventing pneumonia and lower respiratory tract infectionsSpecial Long-Term Care Supplement to Prevention Strategist […] The dirty mouth: Clean it and prevent infection in the long-term care residentAPIC Infection Connection […] Guidelines for Preventing Health-Care-Associated Pneumonia, 2003Centers for Disease Control and Prevention […] How-to Guide: Prevent Ventilator-Associated PneumoniaInstitute for Healthcare Improvement […] The 9 ways to reduce the risk of pneumoniaMonthly alert for consumers […] Influenza and pneumococcal immunizationMonthly alert for consumers.

• #2 Prophylactic antibiotics for preventing ventilator-associated pneumonia: a pairwise and Bayesian network meta-analysis | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01323-z

  The role of prophylactic antibiotics in preventing ventilator-associated pneumonia (VAP) in patients undergoing invasive mechanical ventilation (IMV) remains unclear. This network meta-analysis compared the efficacy and safety of antibiotic prophylaxis in preventing VAP in an IMV population in intensive-care units (ICUs). […] Antibiotic prophylaxis may reduce the incidence of VAP, but not the mortality, for adult patients undergoing IMV in ICUs. Tobramycin via nebulization and ampicillinsulbactam via intravenous administration presented the greatest likelihood of being the most efficient regimen for preventing VAP. […] Several strategies have been put forward for preventing VAP, including regular oral care with chlorhexidine, prophylactic probiotics, prophylactic antibiotics, and using silver-coated endotracheal tubes.

• #2 Nonventilator Hospital-Acquired Pneumonia Prevention: The Key Role for Critical Care Nurses – AACN

  https://www.aacn.org/education/ce-activities/nti23246/nonventilator-hospitalacquired-pneumonia-prevention-the-key-role-for-critical-care-nurses

  Non ventilator hospital-acquired infection (NVHAP) is the most common hospital-acquired infection. […] Critically ill non ventilated patients are among the highest risk for NVHAP, signifying that critical care nurses should lead the way in NVHAP prevention. […] Describe the most recent updates from SHEA/IDSA/APIC/ TJC Practice Recommendations on NVHAP prevention and apply to clinical care.

• #2

  https://journals.lww.com/ajnonline/fulltext/2021/06000/original_research__oral_care_as_prevention_for.21.aspx

  Nonventilator hospital-acquired pneumonia (NV-HAP) presents a serious and largely preventable threat to patient safety in U.S. hospitals. There is an emerging body of evidence on the effectiveness of oral care in preventing NV-HAP. […] These findings add to the growing body of evidence that daily oral care as a means of primary source control may have a role in NV-HAP prevention. […] Given the relatively high risk of NV-HAP, it’s imperative that we gain a better understanding of effective means of prevention. An emerging body of literature addresses the role of oral care in preventing NV-HAP. […] The primary aim of this study was to determine the effectiveness of a universal, standardized oral care protocol in preventing NV-HAP in the acute care setting. […] The intervention consisted of the implementation of a standardized oral care protocol and targeted education.

• #2 Overview of Pneumonia – Lung and Airway Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/lung-and-airway-disorders/pneumonia/overview-of-pneumonia

  The most effective way to prevent pneumonia is to stop smoking. […] Deep-breathing exercises and therapy to remove mucus and secretions from the lungs help prevent pneumonia in people at high risk, such as those who have had chest or abdominal surgery and those who are debilitated. […] Vaccines can help prevent certain pneumonias. Sometimes when an unvaccinated person has contact with a person known to have a virus that can cause pneumonia (such as influenza), doctors will prescribe certain antiviral medications to try to prevent infection and pneumonia. […] Vaccines are available that offer partial protection against pneumonia caused by the bacterium Streptococcus pneumoniae, Haemophilus influenzae type b (only in children), Influenza, Chickenpox (varicella; only in children), COVID-19, and Respiratory syncytial virus (RSV).

• #2

  https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Pneumonia.aspx

  Your child can be vaccinated against pneumococcal infections, a bacterial cause of pneumonia. The American Academy of Pediatrics recommends that all children starting at 2 months of age receive this immunization (called pneumococcal conjugate). A series of doses is given at 2, 4, 6, and 12 to 15 months of age, at the same time that children receive other childhood vaccines. […] Another pneumococcal vaccine (pneumococcal polysaccharide) also is recommended for older children (2 through 5 years of age) who have a high risk of developing a pneumococcal infection. These include children with: […] It’s also recommended for children taking medications or who have diseases that weaken their immune system. Some children with certain medical conditions may need a second dose of the vaccine.

• #2 American Thoracic Society | Urgent Need for Increased Global Access…

  https://site.thoracic.org/about-us/news/urgent-need-for-increased-global-access-to-effective-prevention-and-treatment-of-pneumonia

  Raising awareness and knowledge about pneumonia prevention and treatment. […] Improving access to antibiotics, pulse oximetry and oxygen therapy. […] Encouraging funders to invest in pneumonia research and services and supporting research to implement pneumonia prevention and treatment interventions. […] Pneumonia can be caused by viruses, bacteria, or fungi, but it is often preventable through vaccination, adequate nutrition (including breastfeeding) and improving socioeconomic conditions.

• #2

  https://www.who.int/health-topics/pneumonia

  Pneumonia can be prevented by vaccines. […] People of all ages can reduce their risk of pneumonia by: […] Get vaccinated: Immunization against Hib, pneumococcus, measles, influenza and whooping cough (pertussis) is the most effective way to prevent pneumonia. […] Wash your hands: Maintain good hygiene and washing your hands frequently, especially when caring for others who are sick or after blowing your nose, will keep germs from spreading. […] Address environmental factors: Reduce indoor air pollution by providing affordable clean indoor stoves and stop smoking. […] Maintain healthy lifestyle: Eat a healthy diet, rest and get regular exercise to help you stay well. […] Adequate nutrition is key to improving natural defences, starting with exclusive breastfeeding for the first 6 months of life.

• #2 Seniors, Pneumonia Prevention and Care | Lifeline

  https://www.lifeline.com/blog/seniors-pneumonia-prevention-and-care/

  Senior citizens are more likely to get pneumonia and suffer its severe complications due to the changes that come with aging. […] The most reliable way to prevent pneumonia in the elderly is to get the pneumococcal and influenza vaccine. The pneumococcal vaccine protects you against 23 strains of pneumococcus bacteria. […] Smoking destroys the lungs and makes them more prone to infections. Dropping the vice can help prevent pneumonia. […] Washing hands regularly will help you avoid contracting or transmitting the disease to other people. This is virtually true for caregivers looking after the elderly. You also need to clean and disinfect surfaces in the bathroom and kitchens. […] Staying physically active, eating healthy foods, taking plenty of fluids, and having an adequate sleep can help your stay healthy. It will also improve your immune system to fight all kinds of illnesses.

• #2 Community-Acquired Pneumonia (CAP): Practice Essentials, Overview, Etiology of Community-Acquired Pneumonia

  https://emedicine.medscape.com/article/234240-overview

  Pneumococcal vaccines have been shown to have some efficacy in preventing vaccine-strain pneumococcal pneumonia and invasive disease. […] Annual influenza vaccination has been shown to decrease pneumonia diagnoses, hospitalizations, and cardiac events in certain populations. […] Annual influenza vaccination is recommended in all persons older than 6 months. […] The administration of pneumococcal vaccines is tailored based on an individual’s age, vaccination history, and specific health conditions. […] The Advisory Committee on Immunization Practices (ACIP) recommends the following: Adults aged 50 years and older should receive a pneumococcal conjugate vaccine either PCV15, PCV20, or PCV21. […] For adults aged 65 years or older, shared clinical decision-making is recommended regarding pneumococcal vaccination.

• #2 Community-acquired pneumonia in adults (non COVID-19) – Prevention | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000108/prevention

  Pneumonia prevention is focused on the pathogens that cause disease, through vaccination and by managing the risks associated with disease development. […] The main means of prevention are pneumococcal and influenza vaccination of at-risk people and smoking cessation. […] At-risk patients should be offered pneumococcal immunisation at every opportunity (for example, when immunising against influenza or at routine consultations), and especially at discharge from hospital. […] Adults aged 65 or over, and at-risk groups: annual influenza vaccine provided they do not have a contraindication. […] Smoking cessation is important for all patients, but particularly for those at risk of pneumonia and influenza. […] Cigarette smoking, both active and passive, is a recognised independent risk factor for CAP. […] For all patients with CAP who smoke, offer advice according to national smoking cessation guidelines.

• #2 Battling Pneumonia: Strategies for Prevention and Recovery

  https://www.fccmg.com/blog/battling-pneumonia-strategies-for-prevention-and-recovery

  Smoking irritates and damages the lungs, making them more susceptible to infection. Quitting smoking is the most critical step you can take to improve your lung health and reduce your risk of pneumonia. […] Eating a balanced diet rich in fruits, vegetables, and whole grains gives your body the essential nutrients it needs to fight infections. […] Regular physical activity strengthens your immune system and overall health. […] Adequate sleep is crucial for a healthy immune system. […] Even after recovering from pneumonia, it’s important to prevent future infections. […] Stay up-to-date on your pneumococcal and flu vaccinations to bolster your immune defenses. […] Regular exercise, a healthy diet, and avoiding smoking are crucial for maintaining healthy lungs.

• #2 Pneumonia Guide for Seniors: Recovery & Prevention Tips

  https://floridaseniorconsulting.com/pneumonia-guide-for-seniors/

  Get the pneumococcal vaccine: There are two pneumococcal vaccines available for adults ages 65 years and older – ask your doctor which one is recommended for you. If you have a weakened immune system or certain chronic health conditions, you may qualify for a pneumococcal vaccine before age 65. […] Get your flu shot every year: The flu is one of the most common causes of pneumonia, so staying up to date on your annual vaccines is crucial for prevention. […] Stop smoking cigarettes: Smoking damages the lungs and weakens the immune system, making it harder for your body to fight off a respiratory infection. […] Make healthy lifestyle choices: Regular exercise, a balanced diet, hydration, and sufficient sleep are key to preventing illnesses and keeping your immune system strong, helping you fight off infection more easily. […] By following key prevention strategies—such as getting vaccinated, maintaining good hygiene, and making healthy lifestyle choices—seniors can significantly reduce their risk of contracting pneumonia.

• #2 Core Concepts – Opportunistic Infections: Prevention – Co-Occurring Conditions – National HIV Curriculum

  https://www.hiv.uw.edu/go/co-occurring-conditions/opportunistic-infections-prevention/core-concept/all

  Pneumocystis pneumonia (PCP) is an important cause of morbidity and mortality in persons with HIV. Pneumocystis pneumonia is caused by Pneumocystis jirovecii, a ubiquitous organism that has been classified as a fungus. The Adult and Adolescent OI Guidelines recommend the following indications for initiating primary PCP prophylaxis. […] Prophylaxis is considered primary (preventing the first episode of Pneumocystis pneumonia) or secondary (preventing recurrence of Pneumocystis pneumonia). The Adult and Adolescent OI Guidelines provide recommendations for preferred and alternative agents for Pneumocystis pneumonia primary prophylaxis as outlined in the table below. […] Clinicians providing pre-pregnancy care for women receiving Pneumocystis prophylaxis should consider discussing the option of postponing pregnancy until it is safe to discontinue Pneumocystis prophylaxis.

• #2 Pneumocystis Pneumonia: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/pneumocystis

  CD4 count 100 cells/mm3, regardless of plasma HIV RNA level. […] Preferred Therapy […] TMP-SMX, 1 DS tablet PO daily, or […] TMP-SMX, 1 SS tablet PO daily. […] Indication for Discontinuing Primary Prophylaxis […] CD4 count increased from 200 cells/mm3 to 200 cells/mm3 for 3 months in response to ART. […] Indication for Restarting Primary Prophylaxis […] CD4 count 100 cells/mm3 regardless of HIV RNA. […] TMP-SMX is the recommended prophylactic agent for PCP. […] TMP-SMX chemoprophylaxis should be continued, when clinically feasible, in people with HIV who have non-life threatening adverse reactions. […] For people with HIV who develop PCP despite TMP-SMX prophylaxis usually can be treated effectively with standard doses of TMP-SMX. […] If not already started, ART should be initiated in patients within 2 weeks of diagnosis of PCP, if possible.

• #2 Steroids, Prophylaxis and Pneumocystis Pneumonia | RheumNow

  https://rheumnow.com/news/steroids-prophylaxis-and-pneumocystis-pneumonia

  A case-control study has shown that glucocorticoids and tapering glucocorticoids are risk factors for the development of Pneumocystis jirovecii pneumonia (PJP). […] The authors provide guidance on the optimal timing for prophylaxis use and withdrawal. […] They identified 10 PJP cases (from 1,174 person-years followup) with an incidence rate of 0.85 per 100 person-years. […] In multivariate analysis, risk factors for PJP included age, impaired renal function, lymphopenia, rituximab use and higher doses of GC at the time of TMP-SMX discontinuation. […] Discontinuing TMP-SMX while on a glucocorticoid dose 12.5 mg/day significantly increased the risk of PJP (adjusted hazard ratio: 13.84). […] Tapering glucocorticoids to 12.5 mg/day (prednisone equivalent) could be a reasonable timepoint to initiate the withdrawal of PJP prophylaxis in patients with rheumatic diseases.

• #2 Pneumocystis Pneumonia: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/pneumocystis

  Recommendations for Preventing Recurrence of Pneumocystis Pneumonia (Secondary Prophylaxis) […] Indications for Initiating Secondary Prophylaxis […] Prior PCP. […] Preferred Therapy […] TMP-SMX, 1 DS tablet PO daily, or […] TMP-SMX, 1 SS tablet PO daily. […] Indications for Discontinuing Secondary Prophylaxis […] CD4 count increased from 200 cells/mm3 to 200 cells/mm3 for 3 months as a result of ART. […] If an episode of PCP occurs at a CD4 count 200 cells/mm3 while a patient is on ART, it would be prudent to continue PCP prophylaxis for life.

• #2 Incidence of Pneumocystis jirovecii Pneumonia and Prophylaxis-Associated Adverse Events Among Patients With Systemic Lupus Erythematosus | The Journal of Rheumatology

  https://www.jrheum.org/content/52/1/47

  Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection that may affect patients with systemic lupus erythematosus (SLE). […] The most common PJP prophylaxis was trimethoprim-sulfamethoxazole (n = 1126, 18.7%). […] In the adjusted analysis, patients who received prophylaxis had a higher risk of neutropenia (hazard ratio [HR] 2.5, 95% CI 1.4-4.4), leukopenia (HR 1.9, 95% CI 1.3-2.8), nephropathy (HR 1.7, 95% CI 1.4-2.1), and hyperkalemia (HR 1.4, 95% CI 0.9-2.0). […] Prophylaxis against PJP is associated with adverse events. […] These data do not support universal prescribing of PJP prophylaxis for patients with SLE without lung disease.

• #2 Diffusion Marketplace

  https://marketplace.va.gov/innovations/project-happen

  HAPPEN is an oral care initiative that targets the source of NV-HAP- the patient’s own mouth. […] With consistent oral care, the number of the bacteria in the mouth is reduced. […] All Veterans should be offered assistance with their oral care a minimum of twice daily (e.g. toothbrushing) during their hospital or CLC stay. […] HAPPEN implementing sites are reporting declines in NV-HAP of 40-60% thus saving lives, shortening length of stay, reducing the need for long-term care, and improving patient safety and quality of life. […] With consistent oral care, the risk of hospital acquired pneumonia among non-ventilated patients is decreased an average of 40-60%. […] This video is a reminder for direct care staff about the importance of consistent oral hygiene in prevention of hospital acquired pneumonia.

• #2 Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/10/633

  Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) cause significant inpatient morbidity and mortality. […] The authors describe the diagnosis, management, and prevention of these diseases based on current guidelines and recent evidence. […] Nursing care bundles addressing aspiration risk factors can reduce the incidence of HAP and VAP in the hospital. […] Preventing HAP and VAP is as important as diagnosing and managing them and depends upon multiple approaches to address individual aspiration risk factors and nosocomial transmission of disease. […] Regular oral care, assessment of the need for proton-pump inhibitor and histamine-2-receptor blocker therapy, and early identification and treatment of dysphagia especially in the elderly and in patients with recent stroke or surgical procedures are key features to preventing oropharyngeal colonization of pathogenic organisms, aspiration, and ensuing HAP or VAP.

• #2 Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) – Defeat DD

  https://www.defeatdd.org/resources/reports/global-action-plan-prevention-and-control-pneumonia-and-diarrhoea-gappd/

  The Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD), a global plan published in 2013 by UNICEF and the World Health Organization (WHO), represents the first-ever simultaneous effort to protect children from pneumonia and diarrhoea, the two leading killer diseases of children less than five years old. […] Designed to inform global and national programs and policies, the GAPPD provides a framework to protect children, prevent disease, and treat children who do become sick using proven interventions that have already contributed to major reductions in child deaths. […] The NGO community issued a statement of support for the GAPPD and pledged to begin immediately working with national governments, donors, multilateral institutions, the private sector and other partners to make the global framework a reality in the countries and communities hardest hit. […] Advocacy toolkit for national efforts to promote GAPPD implementation.

• #2 Pneumonia can occur across life’s stages—prevention should too | PATH

  https://www.path.org/our-impact/articles/pneumonia-can-occur-across-lifes-stagesprevention-should-too/

  Immunization is even more powerful in tandem with other pneumonia interventions. […] Whether a person has just been born, is in later life, is expecting a baby, or lives in a poor or remote part of the world shouldnt determine their access to disease prevention. […] To defeat pneumonia, were going to need to go where immunization has never (or rarely) gone before.

• #2 Urgent Need for Increased Global Access to Effective Prevention and Treatment of Pneumonia – ERS – European Respiratory Society

  https://www.ersnet.org/news-and-features/news/urgent-need-for-increased-global-access-to-effective-prevention-and-treatment-of-pneumonia/

  An effective vaccination strategy will reduce the spread of pneumonia, and its impact on the population. […] Appropriate use of antibiotics would offer a more effective treatment strategy and reduce the emergence of drug resistance. […] Pneumonia can be caused by viruses, bacteria, or fungi, but it is often preventable through vaccination, adequate nutrition (including breastfeeding) and improving socioeconomic conditions.

• #3 Pneumonia: Etiology, Care and Prevention | RT

  https://respiratory-therapy.com/disorders-diseases/infectious-diseases/other-infections/pneumonia-etiology-care-and-prevention/

  Pneumonia is a potentially life-threatening infection of the lungs that inflames alveoli and spurs the overproduction of purulent material. […] This article will discuss the different etiologies of pneumonia (including bacterial, viral, fungal), the rise in cases as a result of COVID-19, the ongoing challenge of CAP/HAP/VAP, differences in adult versus pediatric care, and successful strategies for preventing severe cases. […] Prevention of severe pneumonia follows the same foundation as overall prevention of pneumonia. Vaccination against bacterial pneumonia helps reduce incidence of Haemophilus influenzae type b (Hib), pertussis (whooping cough), and pneumococcal pneumonia. Recommended immunizations that fight viral infections help fight issues with COVID-19, influenza (flu), measles, RSV, and varicella.

• #3 Pneumonia: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/4471-pneumonia

  The best way to prevent pneumonia is to get vaccinated against bacteria and viruses that commonly cause it. There are also everyday precautions you can take to help reduce your risk of pneumonia. […] There are two types of vaccines (shots) that prevent pneumonia caused by pneumococcal bacteria. Similar to a flu shot, these vaccines wont protect against all types of pneumonia, but if you do get sick, its less likely to be severe. […] As certain viruses can lead to pneumonia, getting vaccinated against COVID-19 and the flu can help reduce your risk of getting pneumonia. […] In addition to getting vaccinated, you can reduce your risk of getting and spreading pneumonia with some healthy habits: Quit smoking and avoid secondhand smoke. Smoking damages your lungs and makes you more likely to get an infection. […] If you have to stay in a hospital or other healthcare facility, dont be afraid to ask your providers about how to reduce your risk of getting an infection during your stay.

• #3 How Do You Prevent and Treat Pneumonia? Vaccines, Medications, and More

  https://www.everydayhealth.com/pneumonia/guide/treatment/

  While theres no sure way to prevent pneumonia, there are a number of steps you can take to reduce your risk of getting sick. […] The American Lung Association advises talking to your doctor before taking cough medicine, since coughing can help the lungs eliminate phlegm. […] Streptococcus pneumoniae, or pneumococcus, is the most common cause of bacterial pneumonia in adults, and it can be prevented with vaccines. […] The Centers for Disease Control and Prevention (CDC) recommends vaccination for all adults age 50 and older. […] Anyone ages 19 to 49 with certain risk factors that increase their odds of infection complications should talk with their healthcare providers about whether they would benefit from vaccination as well; the type of vaccine and number of doses may vary. […] For all babies and children under age 5, the CDC recommends a four-dose PCV series (PCV15 or PCV20).

• #3 Preventing Pneumonia | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/preventing-pneumonia

  Yes, many cases can be prevented. You can reduce your risk of getting pneumonia by following a few simple steps. Here’s how: […] Being up to date on your recommended vaccines like an annual flu shot can help prevent pneumonia. […] Certain people should get vaccinated against pneumococcal pneumonia, a common form of bacterial pneumonia including: All children younger than 5 years old. […] Additional pneumococcal vaccinations may be recommended for children and adults who are at increased risk of pneumococcal disease depending on their health condition(s). […] There are several other vaccines that can help prevent infections by bacteria and viruses that may lead to pneumonia, including pertussis (whooping cough), chicken pox, Haemophilus influenzae type b (Hib), and measles. […] Tobacco damages your lung’s ability to fight off infection, and people who smoke have been found to be at higher risk of getting pneumonia.

• #3 Patient education: Pneumonia prevention in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/pneumonia-prevention-in-adults-beyond-the-basics/print

  Quitting smoking and avoiding secondhand smoke exposure is an important way to help prevent pneumonia and improve your overall health. […] Washing your hands with soap and water or using an alcohol-based hand sanitizer is one of the most important ways to avoid spreading illness to others, particularly when you have a viral infection such as influenza. […] Living a healthy lifestyle including eating right, exercising, and maintaining a healthy weight can help prevent many health problems. Taking medicines as prescribed, particularly for chronic illnesses that increase the risk of pneumonia, can also help prevent health complications. […] Ensuring that you and those around you are up to date on recommended vaccines can help prevent pneumonia in you, your family, and your community.

• #3 Preventing Pneumonia | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia/preventing-pneumonia

  Good health habits a healthy diet, rest, regular exercise, etc. help keep you from getting sick from viruses and respiratory illnesses. They also help promote faster recovery when you do get a cold, the flu or other respiratory illness. […] Take care to keep well managed existing health conditions such as asthma, COPD, diabetes and heart disease.

• #3 Battling Pneumonia: Strategies for Prevention and Recovery

  https://www.fccmg.com/blog/battling-pneumonia-strategies-for-prevention-and-recovery

  Smoking irritates and damages the lungs, making them more susceptible to infection. Quitting smoking is the most critical step you can take to improve your lung health and reduce your risk of pneumonia. […] Eating a balanced diet rich in fruits, vegetables, and whole grains gives your body the essential nutrients it needs to fight infections. […] Regular physical activity strengthens your immune system and overall health. […] Adequate sleep is crucial for a healthy immune system. […] Even after recovering from pneumonia, it’s important to prevent future infections. […] Stay up-to-date on your pneumococcal and flu vaccinations to bolster your immune defenses. […] Regular exercise, a healthy diet, and avoiding smoking are crucial for maintaining healthy lungs.

• #3 Pneumonia – Symptoms, Causes, Treatment, Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Number for ap

  https://www.pacehospital.com/pneumonia-causes-symptoms-types-treatment-prevention

  Strengthen the immune system: Eating a balanced diet, exercising regularly, and getting enough sleep can strengthen the immune system and reduce susceptibility to infections. […] Avoiding crowded places: Crowding is an essential risk factor for various infectious diseases, making it easier to spread infections like pneumonia. Hence, encouraging young children and persons who are at high risk of pneumonia to avoid crowded places can help reduce the number of people who fall ill with pneumonia. […] Avoiding aspiration: For individuals at risk of aspiration, such as those with swallowing difficulties, it is important to be cautious about food and drink intake to prevent food or liquids from entering the lungs. […] Addressing environmental factors: Avoiding certain environmental factors, such as indoor air pollution and lung irritants like smoking (quitting smoking), can help reduce pneumonia risk. […] Treating the chronic conditions: Managing chronic diseases, especially in older patients, including diabetes, asthma, and heart conditions, can reduce the risk of pneumonia by preventing complications and improving overall health.

• #3 Prevention of Hospital-Acquired Pneumonia: VAP & NV-HAP | Agency for Healthcare Research and Quality

  https://www.ahrq.gov/hai/tools/mrsa-prevention/toolkit/vap.html

  Prevention of VAP and NV-HAP is a crucial, yet sometimes-overlooked aspect of MRSA prevention. […] Discuss the causes and risks associated with hospital-acquired pneumonia. […] Describe the current guidelines and key best practice recommendations for preventing hospital-acquired pneumonia. […] Review the current recommendations for implementation of a bundled approach to reduce hospital-acquired pneumonia. […] Provides a concise summary of key essential practices for prevention of VAP. […] Provides a concise summary of key essential practices for prevention of NV-HAP. […] Follow the below links to access available guidelines on prevention of VAP. […] Follow the below links to access available guidelines on prevention of NV-HAP.

• #3 Recommendations for The Prevention of Ventilator-Associated Pneumonia – ISID

  https://isid.org/guide/hospital/recommendations-for-the-prevention-of-ventilator-associated-pneumonia/

  Avoid intubation and prevent reintubation. […] Minimize sedation. […] Maintain and improve physical conditioning. […] Elevate the head of the bed to 30-45 degrees. […] Provide oral care with toothbrushing but without chlorhexidine. […] Provide early enteral vs. parenteral nutrition. […] Change the ventilator circuit only if visibly soiled or malfunctioning (or per manufacturers instructions). […] Other supplementary interventions encompass interventions linked with reduced rates of VAP, shortened periods of MV ventilation, reduced LOS, and/or decreased mortality, albeit with associated risks. […] It was observed that there is a lack of sufficient education; therefore, an effort should be made to reverse it. […] The empirical evidence delineated in this review incontrovertibly establishes that VAP rates in LMICs persist at a magnitude exceeding tenfold that observed in high-income countries.

• #3 Prophylactic antibiotics for preventing ventilator-associated pneumonia: a pairwise and Bayesian network meta-analysis | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-023-01323-z

  A meta-analysis of the use of preventive antibiotics, published in 2018, provided evidence of the protective effect of antibiotics against VAP. […] Our results indicated that antibiotic prophylaxis via intravenous administration presented as slightly more effective in preventing VAP than administration via the respiratory tract, but the difference was not significant. […] According to our results, antibiotic prophylaxis may reduce the incidence of VAP, but not reduce mortality, for adult patients receiving IMV in ICUs; an NMA demonstrated that tobramycin via nebulization and ampicillinsulbactam via intravenous administration presented the greatest possibility of being the most effective regimens for preventing VAP.

• #3 Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/10/633

  Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) cause significant inpatient morbidity and mortality. […] The authors describe the diagnosis, management, and prevention of these diseases based on current guidelines and recent evidence. […] Nursing care bundles addressing aspiration risk factors can reduce the incidence of HAP and VAP in the hospital. […] Preventing HAP and VAP is as important as diagnosing and managing them and depends upon multiple approaches to address individual aspiration risk factors and nosocomial transmission of disease. […] Regular oral care, assessment of the need for proton-pump inhibitor and histamine-2-receptor blocker therapy, and early identification and treatment of dysphagia especially in the elderly and in patients with recent stroke or surgical procedures are key features to preventing oropharyngeal colonization of pathogenic organisms, aspiration, and ensuing HAP or VAP.

• #3 Preventing pneumonia after surgery | Vancouver Coastal Health

  https://www.vch.ca/en/preventing-pneumonia-after-surgery

  Anytime you are in the hospital, your lungs need help to prevent pneumonia. pneumonia is a potentially life threatening condition and can cause serious complications. […] These simple activities, including early and frequent mobilization, lung exercises, oral hygiene and education will help prevent you from developing lung complications, such as pneumonia, while you are in the hospital. […] Brushing your mouth (teeth, gums and tongue) decreases the amount of germs in your mouth which could move down into your lungs and cause pneumonia. […] Good pain relief is necessary for you to perform the activities described in this pamphlet. Being unable to take a deep breath increases your risk of getting pneumonia.

• #3 Pneumonia: Symptoms, Diagnosis, Treatment and Prevention | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/pneumonia

• #3 Pneumonia in Children: Signs, Treatment, and Prevention

  https://www.webmd.com/children/what-to-know-about-pneumonia-in-children

  The best way to prevent children from getting pneumonia is through vaccination as well as good hygiene practices like regular handwashing and cleaning and disinfecting surfaces. […] The Centers for Disease Control and Prevention (CDC) recommends vaccinating children with tPCV13 or 15, which help prevent pneumonia from developing in children 5 years and younger and in children ages 5-18 who have other medical conditions that make them more vulnerable to pneumonia. […] The pneumococcal polysaccharide (PPV23) pneumonia vaccine is also recommended for children ages 2-18 who have certain medical conditions, and adults 19 years and older who got the PCV15 vaccine.

• #3 Pneumocystis jiroveci Pneumonia (PJP): Overview of Pneumocystis jiroveci Pneumonia, Microbiology of Pneumocystis jiroveci Pneumonia, Pathophysiology and Etiology of Pneumocystis jiroveci Pneumonia

  https://emedicine.medscape.com/article/225976-overview

  Pneumocystis jiroveci pneumonia (PJP) is the most common opportunistic infection in persons with HIV infection. […] Preventive measures (eg, smoking cessation and chemoprophylaxis) can play an important role in disease management. […] Smoking cessation is strongly recommended in patients with HIV infection, as studies have shown that, in addition to the common deleterious effects of tobacco use, smokers are at an increased risk of P jiroveci pneumonia (PJP) and have a more complicated treatment course. […] An expert panel overseen by the US Public Health Service and Infectious Disease Society of America has published guidelines on prophylaxis against P jiroveci pneumonia (PJP) in adult and pediatric patients with HIV infection. Chemoprophylaxis is recommended for the following groups:

• #3 Pneumocystis jirovecii pneumonia prophylaxis in PWH – SHEA

  https://shea-online.org/shea-journal-club/june-2024/pneumocystis-jirovecii-pneumonia-prophylaxis-in-pwh/

  A network meta-analysis concludes that TMP-SMX remains the most effective agent for PJP prophylaxis in PWH and is the only agent associated with PJP-related & all-cause mortality benefit. […] Prophylactic regimens include trimethoprim-sulfamethoxazole (TMP-SMX), dapsone-based regimens (DBRs), atovaquone, and aerosolized pentamidine (AP). […] The authors found that TMP-SMX is the most effective agent for PJP prophylaxis in PWH and is the only agent to confer a mortality benefit compared with no treatment/placebo but has a higher risk of discontinuation due to adverse events. […] In conclusion, TMP-SMX should continue to be recommended as the first-line agent for prophylaxis among PJP.

• #3 Core Concepts – Opportunistic Infections: Prevention – Co-Occurring Conditions – National HIV Curriculum

  https://www.hiv.uw.edu/go/co-occurring-conditions/opportunistic-infections-prevention/core-concept/all

  Primary prophylaxis against Pneumocystis pneumonia should be discontinued when possible to reduce pill burden, minimize risk of drug toxicity, and prevent the selection of antibiotic-resistant pathogens, especially if using trimethoprim-sulfamethoxazole. […] Primary prophylaxis for Pneumocystis pneumonia should be restarted if (1) the CD4 count declines to less than 100 cells/mm3 regardless of HIV RNA level or (2) if the CD4 count is 100 to 200 cells/mm3 and the HIV RNA is consistently above the detection limit of the assay. […] Adverse reactions to trimethoprim-sulfamethoxazole occur in more than 15% of people with HIV who take it, and these reactions include rash, fever, nausea, hyperkalemia, azotemia, leukopenia, thrombocytopenia, and a transient increase in hepatic aminotransferase levels.

• #3 American Thoracic Society | Urgent Need for Increased Global Access…

  https://site.thoracic.org/about-us/news/urgent-need-for-increased-global-access-to-effective-prevention-and-treatment-of-pneumonia

  Pneumonia is the leading cause of death in young children. Over 650,000 children under 5 die from pneumonia each year – especially in low- and middle-income countries (LMICs). Pneumonia can be prevented and treated. […] There are several effective preventive strategies for pneumonia, including: good nutrition, prevention of HIV, hand washing, reducing exposure to indoor and outdoor air pollution, and effective vaccines. […] Treating pneumonia requires access to effective antibiotics and oxygen, but this too is still suboptimal in many LMICs. […] On World Pneumonia Day, FIRS calls on governments and other stakeholders to take urgent action to tackle pneumonia by: […] Ensuring that all children and vulnerable adults receive effective pneumonia vaccines. […] Reducing air pollution and exposure to air pollutants and promoting good nutrition, hygiene practices, and smoking cessation to reduce the risk of pneumonia.

• #3 Urgent Need for Increased Global Access to Effective Prevention and Treatment of Pneumonia – ERS – European Respiratory Society

  https://www.ersnet.org/news-and-features/news/urgent-need-for-increased-global-access-to-effective-prevention-and-treatment-of-pneumonia/

  On World Pneumonia Day, 12 November, the Forum of International Respiratory Societies (FIRS), of which the European Respiratory Society is a founding member, is highlighting the urgent challenges in pneumonia prevention and treatment globally. […] However, pneumonia can be prevented and treated. […] There are several effective preventive strategies for pneumonia, including: good nutrition, prevention of HIV, hand washing, reducing exposure to indoor and outdoor air pollution, and effective vaccines. […] With effective preventive and treatment strategies, dramatic reductions in mortality and improved childhood survival, as outlined in Sustainable Development Goal 3.2, should be possible. […] On World Pneumonia Day, FIRS calls on governments and other stakeholders to take urgent action to tackle pneumonia by:

• #3 FIRS calls for urgent action to expand access to pneumonia prevention and treatment worldwide – ERS – European Respiratory Society

  https://www.ersnet.org/news-and-features/news/firs-calls-for-urgent-action-to-expand-access-to-pneumonia-prevention-and-treatment-worldwide/

  Although pneumonia deaths have substantially declined over the past decade, urgent efforts are still needed to improve access to effective prevention and treatment. On World Pneumonia Day, FIRS is calling on governments and partners to: Ensure equitable and sustained access to vaccines against the commonest pathogens. […] Ensure access to new highly effective preventive interventions against RSV for infants and young children globally. […] Strengthen health systems to deliver interventions which reduce pneumonia deaths, including provision of effective vaccines, antibiotics and oxygen delivery systems. […] Strengthen national and international commitment to support interventions against the leading risk factors for pneumonia. […] Improve support for research into cost-effective interventions to prevent and treat pneumonia in LMICs.

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