Pneumogene Sepsis

The lung is the most important site for septic infections with a remarkable morbidity and mortality. Early diagnosis and early initial antibiotic therapy is the key factor for patient outcome. In patients with community-acquired pneumonia, Streptococcus pneumoniae is the most relevant pathogen. Beta-lactam/macrolide combination therapy is recommended. In patients with sepsis due to nosocomial pneumonia, Staphylococcus aureus, Enterobacteriaceae and Pseudomonas aeruginosa play a role. Broad-spectrum, high-dose antibiotic treatment is necessary. Combination therapy for these patients is discussed controversially. Glycopeptides and linezolid are the treatment of choice for septic MRSA pneumonia. A protective ventilation strategy with low tidal volume (4–6 ml/kg body weight) and moderate PEEP (12–15 cm H₂O) is recommended for patients who need mechanical ventilation. High-frequency oscillation or extracorporeal lung assist could be alternatives in highly experienced centres.