id sid tid token lemma pos cord-017784-4r3fpmlb 1 1 key key JJ cord-017784-4r3fpmlb 1 2 : : : cord-017784-4r3fpmlb 1 3 cord-017784 cord-017784 NN cord-017784-4r3fpmlb 1 4 - - HYPH cord-017784-4r3fpmlb 1 5 4r3fpmlb 4r3fpmlb CD cord-017784-4r3fpmlb 2 1 authors author NNS cord-017784-4r3fpmlb 2 2 : : : cord-017784-4r3fpmlb 2 3 Foccillo Foccillo NNP cord-017784-4r3fpmlb 2 4 , , , cord-017784-4r3fpmlb 2 5 Giampiero Giampiero NNP cord-017784-4r3fpmlb 2 6 title title NN cord-017784-4r3fpmlb 2 7 : : : cord-017784-4r3fpmlb 3 1 The the DT cord-017784-4r3fpmlb 3 2 Infections infection NNS cord-017784-4r3fpmlb 3 3 Causing cause VBG cord-017784-4r3fpmlb 3 4 Acute acute JJ cord-017784-4r3fpmlb 3 5 Respiratory respiratory JJ cord-017784-4r3fpmlb 3 6 Failure failure NN cord-017784-4r3fpmlb 3 7 in in IN cord-017784-4r3fpmlb 3 8 Elderly Elderly NNP cord-017784-4r3fpmlb 3 9 Patients Patients NNP cord-017784-4r3fpmlb 3 10 date date NN cord-017784-4r3fpmlb 3 11 : : : cord-017784-4r3fpmlb 3 12 2019 2019 CD cord-017784-4r3fpmlb 3 13 - - HYPH cord-017784-4r3fpmlb 3 14 08 08 CD cord-017784-4r3fpmlb 3 15 - - HYPH cord-017784-4r3fpmlb 3 16 06 06 CD cord-017784-4r3fpmlb 3 17 journal journal NN cord-017784-4r3fpmlb 3 18 : : : cord-017784-4r3fpmlb 3 19 Ventilatory Ventilatory NNP cord-017784-4r3fpmlb 3 20 Support Support NNP cord-017784-4r3fpmlb 3 21 and and CC cord-017784-4r3fpmlb 3 22 Oxygen Oxygen NNP cord-017784-4r3fpmlb 3 23 Therapy Therapy NNP cord-017784-4r3fpmlb 3 24 in in IN cord-017784-4r3fpmlb 3 25 Elder Elder NNP cord-017784-4r3fpmlb 3 26 , , , cord-017784-4r3fpmlb 3 27 Palliative Palliative NNP cord-017784-4r3fpmlb 3 28 and and CC cord-017784-4r3fpmlb 3 29 End end NN cord-017784-4r3fpmlb 3 30 - - HYPH cord-017784-4r3fpmlb 3 31 of of IN cord-017784-4r3fpmlb 3 32 - - HYPH cord-017784-4r3fpmlb 3 33 Life life NN cord-017784-4r3fpmlb 3 34 Care Care NNP cord-017784-4r3fpmlb 3 35 Patients patient NNS cord-017784-4r3fpmlb 3 36 DOI DOI NNP cord-017784-4r3fpmlb 3 37 : : : cord-017784-4r3fpmlb 3 38 10.1007/978 10.1007/978 CD cord-017784-4r3fpmlb 3 39 - - HYPH cord-017784-4r3fpmlb 3 40 3 3 CD cord-017784-4r3fpmlb 3 41 - - HYPH cord-017784-4r3fpmlb 3 42 030 030 CD cord-017784-4r3fpmlb 3 43 - - HYPH cord-017784-4r3fpmlb 3 44 26664 26664 CD cord-017784-4r3fpmlb 3 45 - - SYM cord-017784-4r3fpmlb 3 46 6_5 6_5 CD cord-017784-4r3fpmlb 3 47 sha sha NNP cord-017784-4r3fpmlb 3 48 : : : cord-017784-4r3fpmlb 3 49 95389a6df57c4ff3cb374ef521db1ec86ffbe513 95389a6df57c4ff3cb374ef521db1ec86ffbe513 CD cord-017784-4r3fpmlb 3 50 doc_id doc_id CD cord-017784-4r3fpmlb 3 51 : : : cord-017784-4r3fpmlb 3 52 17784 17784 CD cord-017784-4r3fpmlb 3 53 cord_uid cord_uid NNS cord-017784-4r3fpmlb 3 54 : : : cord-017784-4r3fpmlb 3 55 4r3fpmlb 4r3fpmlb CD cord-017784-4r3fpmlb 4 1 The the DT cord-017784-4r3fpmlb 4 2 immune immune JJ cord-017784-4r3fpmlb 4 3 system system NN cord-017784-4r3fpmlb 4 4 of of IN cord-017784-4r3fpmlb 4 5 older old JJR cord-017784-4r3fpmlb 4 6 individuals individual NNS cord-017784-4r3fpmlb 4 7 declines decline VBZ cord-017784-4r3fpmlb 4 8 with with IN cord-017784-4r3fpmlb 4 9 advancing advance VBG cord-017784-4r3fpmlb 4 10 age age NN cord-017784-4r3fpmlb 4 11 ( ( -LRB- cord-017784-4r3fpmlb 4 12 “ " `` cord-017784-4r3fpmlb 4 13 immunosenescence immunosenescence NNP cord-017784-4r3fpmlb 4 14 ” " '' cord-017784-4r3fpmlb 4 15 ) ) -RRB- cord-017784-4r3fpmlb 5 1 increasing increase VBG cord-017784-4r3fpmlb 5 2 susceptibility susceptibility NN cord-017784-4r3fpmlb 5 3 to to IN cord-017784-4r3fpmlb 5 4 infection infection NN cord-017784-4r3fpmlb 5 5 , , , cord-017784-4r3fpmlb 5 6 as as RB cord-017784-4r3fpmlb 5 7 well well RB cord-017784-4r3fpmlb 5 8 as as IN cord-017784-4r3fpmlb 5 9 to to IN cord-017784-4r3fpmlb 5 10 an an DT cord-017784-4r3fpmlb 5 11 increased increase VBN cord-017784-4r3fpmlb 5 12 risk risk NN cord-017784-4r3fpmlb 5 13 of of IN cord-017784-4r3fpmlb 5 14 a a DT cord-017784-4r3fpmlb 5 15 worse bad JJR cord-017784-4r3fpmlb 5 16 outcome outcome NN cord-017784-4r3fpmlb 5 17 . . . cord-017784-4r3fpmlb 6 1 Severe severe JJ cord-017784-4r3fpmlb 6 2 community community NN cord-017784-4r3fpmlb 6 3 - - HYPH cord-017784-4r3fpmlb 6 4 acquired acquire VBN cord-017784-4r3fpmlb 6 5 pneumonia pneumonia NN cord-017784-4r3fpmlb 6 6 and and CC cord-017784-4r3fpmlb 6 7 acute acute JJ cord-017784-4r3fpmlb 6 8 exacerbations exacerbation NNS cord-017784-4r3fpmlb 6 9 of of IN cord-017784-4r3fpmlb 6 10 chronic chronic JJ cord-017784-4r3fpmlb 6 11 obstructive obstructive JJ cord-017784-4r3fpmlb 6 12 pulmonary pulmonary JJ cord-017784-4r3fpmlb 6 13 disease disease NN cord-017784-4r3fpmlb 6 14 ( ( -LRB- cord-017784-4r3fpmlb 6 15 AECOPD AECOPD NNP cord-017784-4r3fpmlb 6 16 ) ) -RRB- cord-017784-4r3fpmlb 6 17 are be VBP cord-017784-4r3fpmlb 6 18 causes cause NNS cord-017784-4r3fpmlb 6 19 of of IN cord-017784-4r3fpmlb 6 20 acute acute JJ cord-017784-4r3fpmlb 6 21 respiratory respiratory JJ cord-017784-4r3fpmlb 6 22 failure failure NN cord-017784-4r3fpmlb 6 23 ( ( -LRB- cord-017784-4r3fpmlb 6 24 ARF ARF NNP cord-017784-4r3fpmlb 6 25 ) ) -RRB- cord-017784-4r3fpmlb 6 26 in in IN cord-017784-4r3fpmlb 6 27 elderly elderly JJ cord-017784-4r3fpmlb 6 28 patients patient NNS cord-017784-4r3fpmlb 6 29 . . . cord-017784-4r3fpmlb 7 1 Non non JJ cord-017784-4r3fpmlb 7 2 - - JJ cord-017784-4r3fpmlb 7 3 invasive invasive JJ cord-017784-4r3fpmlb 7 4 mechanical mechanical JJ cord-017784-4r3fpmlb 7 5 ventilation ventilation NN cord-017784-4r3fpmlb 7 6 ( ( -LRB- cord-017784-4r3fpmlb 7 7 NIV NIV NNP cord-017784-4r3fpmlb 7 8 ) ) -RRB- cord-017784-4r3fpmlb 7 9 is be VBZ cord-017784-4r3fpmlb 7 10 effective effective JJ cord-017784-4r3fpmlb 7 11 in in IN cord-017784-4r3fpmlb 7 12 the the DT cord-017784-4r3fpmlb 7 13 treatment treatment NN cord-017784-4r3fpmlb 7 14 of of IN cord-017784-4r3fpmlb 7 15 patients patient NNS cord-017784-4r3fpmlb 7 16 with with IN cord-017784-4r3fpmlb 7 17 ARF ARF NNP cord-017784-4r3fpmlb 7 18 , , , cord-017784-4r3fpmlb 7 19 above above IN cord-017784-4r3fpmlb 7 20 all all DT cord-017784-4r3fpmlb 7 21 in in IN cord-017784-4r3fpmlb 7 22 case case NN cord-017784-4r3fpmlb 7 23 of of IN cord-017784-4r3fpmlb 7 24 AECOPD AECOPD NNP cord-017784-4r3fpmlb 7 25 . . . cord-017784-4r3fpmlb 8 1 Aging age VBG cord-017784-4r3fpmlb 8 2 is be VBZ cord-017784-4r3fpmlb 8 3 accompanied accompany VBN cord-017784-4r3fpmlb 8 4 by by IN cord-017784-4r3fpmlb 8 5 profound profound JJ cord-017784-4r3fpmlb 8 6 morphological morphological JJ cord-017784-4r3fpmlb 8 7 and and CC cord-017784-4r3fpmlb 8 8 physiological physiological JJ cord-017784-4r3fpmlb 8 9 alterations alteration NNS cord-017784-4r3fpmlb 8 10 . . . cord-017784-4r3fpmlb 9 1 In in IN cord-017784-4r3fpmlb 9 2 particular particular JJ cord-017784-4r3fpmlb 9 3 , , , cord-017784-4r3fpmlb 9 4 the the DT cord-017784-4r3fpmlb 9 5 immune immune JJ cord-017784-4r3fpmlb 9 6 system system NN cord-017784-4r3fpmlb 9 7 undergoes undergo VBZ cord-017784-4r3fpmlb 9 8 a a DT cord-017784-4r3fpmlb 9 9 complex complex JJ cord-017784-4r3fpmlb 9 10 series series NN cord-017784-4r3fpmlb 9 11 of of IN cord-017784-4r3fpmlb 9 12 remodeling remodeling NN cord-017784-4r3fpmlb 9 13 / / SYM cord-017784-4r3fpmlb 9 14 restructuring restructuring NN cord-017784-4r3fpmlb 9 15 events event NNS cord-017784-4r3fpmlb 9 16 , , , cord-017784-4r3fpmlb 9 17 involving involve VBG cord-017784-4r3fpmlb 9 18 almost almost RB cord-017784-4r3fpmlb 9 19 all all DT cord-017784-4r3fpmlb 9 20 compartments compartment NNS cord-017784-4r3fpmlb 9 21 , , , cord-017784-4r3fpmlb 9 22 both both DT cord-017784-4r3fpmlb 9 23 cell cell NN cord-017784-4r3fpmlb 9 24 - - HYPH cord-017784-4r3fpmlb 9 25 mediated mediate VBN cord-017784-4r3fpmlb 9 26 immunity immunity NN cord-017784-4r3fpmlb 9 27 and and CC cord-017784-4r3fpmlb 9 28 humoral humoral JJ cord-017784-4r3fpmlb 9 29 immune immune JJ cord-017784-4r3fpmlb 9 30 responses response NNS cord-017784-4r3fpmlb 9 31 . . . cord-017784-4r3fpmlb 10 1 This this DT cord-017784-4r3fpmlb 10 2 process process NN cord-017784-4r3fpmlb 10 3 termed term VBD cord-017784-4r3fpmlb 10 4 immunosenescence immunosenescence JJ cord-017784-4r3fpmlb 10 5 or or CC cord-017784-4r3fpmlb 10 6 immune immune JJ cord-017784-4r3fpmlb 10 7 dysregulation dysregulation NN cord-017784-4r3fpmlb 10 8 , , , cord-017784-4r3fpmlb 10 9 together together RB cord-017784-4r3fpmlb 10 10 changes change NNS cord-017784-4r3fpmlb 10 11 in in IN cord-017784-4r3fpmlb 10 12 lung lung NN cord-017784-4r3fpmlb 10 13 function function NN cord-017784-4r3fpmlb 10 14 who who WP cord-017784-4r3fpmlb 10 15 occur occur VBP cord-017784-4r3fpmlb 10 16 with with IN cord-017784-4r3fpmlb 10 17 advancing advance VBG cord-017784-4r3fpmlb 10 18 age age NN cord-017784-4r3fpmlb 10 19 , , , cord-017784-4r3fpmlb 10 20 play play VB cord-017784-4r3fpmlb 10 21 a a DT cord-017784-4r3fpmlb 10 22 critical critical JJ cord-017784-4r3fpmlb 10 23 role role NN cord-017784-4r3fpmlb 10 24 in in IN cord-017784-4r3fpmlb 10 25 the the DT cord-017784-4r3fpmlb 10 26 manifestation manifestation NN cord-017784-4r3fpmlb 10 27 of of IN cord-017784-4r3fpmlb 10 28 age age NN cord-017784-4r3fpmlb 10 29 - - HYPH cord-017784-4r3fpmlb 10 30 related relate VBN cord-017784-4r3fpmlb 10 31 pulmonary pulmonary JJ cord-017784-4r3fpmlb 10 32 diseases disease NNS cord-017784-4r3fpmlb 10 33 such such JJ cord-017784-4r3fpmlb 10 34 as as IN cord-017784-4r3fpmlb 10 35 infections infection NNS cord-017784-4r3fpmlb 10 36 ( ( -LRB- cord-017784-4r3fpmlb 10 37 i.e. i.e. FW cord-017784-4r3fpmlb 10 38 , , , cord-017784-4r3fpmlb 10 39 pneumonia pneumonia NN cord-017784-4r3fpmlb 10 40 ) ) -RRB- cord-017784-4r3fpmlb 10 41 , , , cord-017784-4r3fpmlb 10 42 chronic chronic JJ cord-017784-4r3fpmlb 10 43 obstructive obstructive JJ cord-017784-4r3fpmlb 10 44 pulmonary pulmonary JJ cord-017784-4r3fpmlb 10 45 disease disease NN cord-017784-4r3fpmlb 10 46 ( ( -LRB- cord-017784-4r3fpmlb 10 47 COPD COPD NNP cord-017784-4r3fpmlb 10 48 ) ) -RRB- cord-017784-4r3fpmlb 10 49 , , , cord-017784-4r3fpmlb 10 50 and and CC cord-017784-4r3fpmlb 10 51 increased increase VBD cord-017784-4r3fpmlb 10 52 the the DT cord-017784-4r3fpmlb 10 53 risk risk NN cord-017784-4r3fpmlb 10 54 for for IN cord-017784-4r3fpmlb 10 55 develop develop VB cord-017784-4r3fpmlb 10 56 sepsis sepsis NN cord-017784-4r3fpmlb 10 57 [ [ -LRB- cord-017784-4r3fpmlb 10 58 1 1 CD cord-017784-4r3fpmlb 10 59 ] ] -RRB- cord-017784-4r3fpmlb 10 60 . . . cord-017784-4r3fpmlb 11 1 Respiratory respiratory JJ cord-017784-4r3fpmlb 11 2 failure failure NN cord-017784-4r3fpmlb 11 3 is be VBZ cord-017784-4r3fpmlb 11 4 not not RB cord-017784-4r3fpmlb 11 5 a a DT cord-017784-4r3fpmlb 11 6 disease disease NN cord-017784-4r3fpmlb 11 7 per per FW cord-017784-4r3fpmlb 11 8 se se FW cord-017784-4r3fpmlb 11 9 but but CC cord-017784-4r3fpmlb 11 10 a a DT cord-017784-4r3fpmlb 11 11 consequence consequence NN cord-017784-4r3fpmlb 11 12 of of IN cord-017784-4r3fpmlb 11 13 the the DT cord-017784-4r3fpmlb 11 14 problems problem NNS cord-017784-4r3fpmlb 11 15 that that WDT cord-017784-4r3fpmlb 11 16 interfere interfere VBP cord-017784-4r3fpmlb 11 17 with with IN cord-017784-4r3fpmlb 11 18 the the DT cord-017784-4r3fpmlb 11 19 ability ability NN cord-017784-4r3fpmlb 11 20 to to TO cord-017784-4r3fpmlb 11 21 breathe breathe VB cord-017784-4r3fpmlb 11 22 . . . cord-017784-4r3fpmlb 12 1 The the DT cord-017784-4r3fpmlb 12 2 term term NN cord-017784-4r3fpmlb 12 3 refers refer VBZ cord-017784-4r3fpmlb 12 4 to to IN cord-017784-4r3fpmlb 12 5 the the DT cord-017784-4r3fpmlb 12 6 inability inability NN cord-017784-4r3fpmlb 12 7 to to TO cord-017784-4r3fpmlb 12 8 perform perform VB cord-017784-4r3fpmlb 12 9 adequately adequately RB cord-017784-4r3fpmlb 12 10 the the DT cord-017784-4r3fpmlb 12 11 fundamental fundamental JJ cord-017784-4r3fpmlb 12 12 functions function NNS cord-017784-4r3fpmlb 12 13 of of IN cord-017784-4r3fpmlb 12 14 respiration respiration NN cord-017784-4r3fpmlb 12 15 : : : cord-017784-4r3fpmlb 12 16 to to TO cord-017784-4r3fpmlb 12 17 deliver deliver VB cord-017784-4r3fpmlb 12 18 oxygen oxygen NN cord-017784-4r3fpmlb 12 19 to to IN cord-017784-4r3fpmlb 12 20 the the DT cord-017784-4r3fpmlb 12 21 blood blood NN cord-017784-4r3fpmlb 12 22 and and CC cord-017784-4r3fpmlb 12 23 to to TO cord-017784-4r3fpmlb 12 24 eliminate eliminate VB cord-017784-4r3fpmlb 12 25 carbon carbon NN cord-017784-4r3fpmlb 12 26 dioxide dioxide NN cord-017784-4r3fpmlb 12 27 from from IN cord-017784-4r3fpmlb 12 28 it -PRON- PRP cord-017784-4r3fpmlb 12 29 . . . cord-017784-4r3fpmlb 13 1 Respiratory respiratory JJ cord-017784-4r3fpmlb 13 2 failure failure NN cord-017784-4r3fpmlb 13 3 has have VBZ cord-017784-4r3fpmlb 13 4 many many JJ cord-017784-4r3fpmlb 13 5 causes cause NNS cord-017784-4r3fpmlb 13 6 and and CC cord-017784-4r3fpmlb 13 7 can can MD cord-017784-4r3fpmlb 13 8 come come VB cord-017784-4r3fpmlb 13 9 on on RP cord-017784-4r3fpmlb 13 10 abruptly abruptly RB cord-017784-4r3fpmlb 13 11 ( ( -LRB- cord-017784-4r3fpmlb 13 12 acute acute JJ cord-017784-4r3fpmlb 13 13 respiratory respiratory JJ cord-017784-4r3fpmlb 13 14 failure failure NN cord-017784-4r3fpmlb 13 15 ) ) -RRB- cord-017784-4r3fpmlb 13 16 , , , cord-017784-4r3fpmlb 13 17 when when WRB cord-017784-4r3fpmlb 13 18 the the DT cord-017784-4r3fpmlb 13 19 underlying underlying JJ cord-017784-4r3fpmlb 13 20 cause cause NN cord-017784-4r3fpmlb 13 21 progresses progress VBZ cord-017784-4r3fpmlb 13 22 rapidly rapidly RB cord-017784-4r3fpmlb 13 23 , , , cord-017784-4r3fpmlb 13 24 or or CC cord-017784-4r3fpmlb 13 25 slowly slowly RB cord-017784-4r3fpmlb 13 26 ( ( -LRB- cord-017784-4r3fpmlb 13 27 chronic chronic JJ cord-017784-4r3fpmlb 13 28 respiratory respiratory JJ cord-017784-4r3fpmlb 13 29 failure failure NN cord-017784-4r3fpmlb 13 30 ) ) -RRB- cord-017784-4r3fpmlb 13 31 , , , cord-017784-4r3fpmlb 13 32 when when WRB cord-017784-4r3fpmlb 13 33 it -PRON- PRP cord-017784-4r3fpmlb 13 34 is be VBZ cord-017784-4r3fpmlb 13 35 associated associate VBN cord-017784-4r3fpmlb 13 36 over over IN cord-017784-4r3fpmlb 13 37 months month NNS cord-017784-4r3fpmlb 13 38 or or CC cord-017784-4r3fpmlb 13 39 even even RB cord-017784-4r3fpmlb 13 40 years year NNS cord-017784-4r3fpmlb 13 41 with with IN cord-017784-4r3fpmlb 13 42 a a DT cord-017784-4r3fpmlb 13 43 progressive progressive JJ cord-017784-4r3fpmlb 13 44 underlying underlying JJ cord-017784-4r3fpmlb 13 45 process process NN cord-017784-4r3fpmlb 13 46 . . . cord-017784-4r3fpmlb 14 1 Triggering trigger VBG cord-017784-4r3fpmlb 14 2 causes cause NNS cord-017784-4r3fpmlb 14 3 of of IN cord-017784-4r3fpmlb 14 4 ARF arf NN cord-017784-4r3fpmlb 14 5 in in IN cord-017784-4r3fpmlb 14 6 advanced advanced JJ cord-017784-4r3fpmlb 14 7 aged aged JJ cord-017784-4r3fpmlb 14 8 patients patient NNS cord-017784-4r3fpmlb 14 9 are be VBP cord-017784-4r3fpmlb 14 10 especially especially RB cord-017784-4r3fpmlb 14 11 acute acute JJ cord-017784-4r3fpmlb 14 12 heart heart NN cord-017784-4r3fpmlb 14 13 decompensation decompensation NN cord-017784-4r3fpmlb 14 14 , , , cord-017784-4r3fpmlb 14 15 severe severe JJ cord-017784-4r3fpmlb 14 16 community community NN cord-017784-4r3fpmlb 14 17 - - HYPH cord-017784-4r3fpmlb 14 18 acquired acquire VBN cord-017784-4r3fpmlb 14 19 pneumonia pneumonia NN cord-017784-4r3fpmlb 14 20 ( ( -LRB- cord-017784-4r3fpmlb 14 21 CAP CAP NNP cord-017784-4r3fpmlb 14 22 ) ) -RRB- cord-017784-4r3fpmlb 14 23 , , , cord-017784-4r3fpmlb 14 24 acute acute JJ cord-017784-4r3fpmlb 14 25 exacerbations exacerbation NNS cord-017784-4r3fpmlb 14 26 of of IN cord-017784-4r3fpmlb 14 27 COPD COPD NNP cord-017784-4r3fpmlb 14 28 ( ( -LRB- cord-017784-4r3fpmlb 14 29 AECOPD AECOPD NNP cord-017784-4r3fpmlb 14 30 ) ) -RRB- cord-017784-4r3fpmlb 14 31 , , , cord-017784-4r3fpmlb 14 32 and and CC cord-017784-4r3fpmlb 14 33 pulmonary pulmonary JJ cord-017784-4r3fpmlb 14 34 embolism embolism NN cord-017784-4r3fpmlb 14 35 . . . cord-017784-4r3fpmlb 15 1 Pneumothorax pneumothorax NN cord-017784-4r3fpmlb 15 2 , , , cord-017784-4r3fpmlb 15 3 lung lung NN cord-017784-4r3fpmlb 15 4 cancer cancer NN cord-017784-4r3fpmlb 15 5 , , , cord-017784-4r3fpmlb 15 6 severe severe JJ cord-017784-4r3fpmlb 15 7 sepsis sepsis NN cord-017784-4r3fpmlb 15 8 , , , cord-017784-4r3fpmlb 15 9 and and CC cord-017784-4r3fpmlb 15 10 acute acute JJ cord-017784-4r3fpmlb 15 11 asthma asthma NN cord-017784-4r3fpmlb 15 12 were be VBD cord-017784-4r3fpmlb 15 13 less less RBR cord-017784-4r3fpmlb 15 14 frequent frequent JJ cord-017784-4r3fpmlb 15 15 ( ( -LRB- cord-017784-4r3fpmlb 15 16 < < XX cord-017784-4r3fpmlb 15 17 5 5 CD cord-017784-4r3fpmlb 15 18 % % NN cord-017784-4r3fpmlb 15 19 ) ) -RRB- cord-017784-4r3fpmlb 16 1 [ [ -LRB- cord-017784-4r3fpmlb 16 2 2 2 CD cord-017784-4r3fpmlb 16 3 ] ] -RRB- cord-017784-4r3fpmlb 16 4 . . . cord-017784-4r3fpmlb 17 1 Acute acute JJ cord-017784-4r3fpmlb 17 2 respiratory respiratory JJ cord-017784-4r3fpmlb 17 3 failure failure NN cord-017784-4r3fpmlb 17 4 is be VBZ cord-017784-4r3fpmlb 17 5 a a DT cord-017784-4r3fpmlb 17 6 condition condition NN cord-017784-4r3fpmlb 17 7 in in IN cord-017784-4r3fpmlb 17 8 which which WDT cord-017784-4r3fpmlb 17 9 the the DT cord-017784-4r3fpmlb 17 10 respiratory respiratory JJ cord-017784-4r3fpmlb 17 11 system system NN cord-017784-4r3fpmlb 17 12 fails fail VBZ cord-017784-4r3fpmlb 17 13 in in IN cord-017784-4r3fpmlb 17 14 one one CD cord-017784-4r3fpmlb 17 15 or or CC cord-017784-4r3fpmlb 17 16 both both DT cord-017784-4r3fpmlb 17 17 of of IN cord-017784-4r3fpmlb 17 18 its -PRON- PRP$ cord-017784-4r3fpmlb 17 19 gas gas NN cord-017784-4r3fpmlb 17 20 functions function NNS cord-017784-4r3fpmlb 17 21 , , , cord-017784-4r3fpmlb 17 22 i.e. i.e. FW cord-017784-4r3fpmlb 17 23 , , , cord-017784-4r3fpmlb 17 24 oxygenation oxygenation NN cord-017784-4r3fpmlb 17 25 ( ( -LRB- cord-017784-4r3fpmlb 17 26 PaO pao NN cord-017784-4r3fpmlb 17 27 2 2 CD cord-017784-4r3fpmlb 17 28 < < XX cord-017784-4r3fpmlb 17 29 60 60 CD cord-017784-4r3fpmlb 17 30 mmHg mmHg NNS cord-017784-4r3fpmlb 17 31 ) ) -RRB- cord-017784-4r3fpmlb 17 32 of of IN cord-017784-4r3fpmlb 17 33 and/or and/or CC cord-017784-4r3fpmlb 17 34 elimination elimination NN cord-017784-4r3fpmlb 17 35 of of IN cord-017784-4r3fpmlb 17 36 carbon carbon NN cord-017784-4r3fpmlb 17 37 dioxide dioxide NN cord-017784-4r3fpmlb 17 38 ( ( -LRB- cord-017784-4r3fpmlb 17 39 arterial arterial JJ cord-017784-4r3fpmlb 17 40 carbon carbon NN cord-017784-4r3fpmlb 17 41 dioxide dioxide NN cord-017784-4r3fpmlb 17 42 tension tension NN cord-017784-4r3fpmlb 17 43 ( ( -LRB- cord-017784-4r3fpmlb 17 44 PaCO paco NN cord-017784-4r3fpmlb 17 45 2 2 CD cord-017784-4r3fpmlb 17 46 ) ) -RRB- cord-017784-4r3fpmlb 17 47 > > NFP cord-017784-4r3fpmlb 17 48 45 45 CD cord-017784-4r3fpmlb 17 49 mmHg mmHg NNS cord-017784-4r3fpmlb 17 50 ) ) -RRB- cord-017784-4r3fpmlb 17 51 . . . cord-017784-4r3fpmlb 18 1 In in IN cord-017784-4r3fpmlb 18 2 practice practice NN cord-017784-4r3fpmlb 18 3 , , , cord-017784-4r3fpmlb 18 4 it -PRON- PRP cord-017784-4r3fpmlb 18 5 may may MD cord-017784-4r3fpmlb 18 6 be be VB cord-017784-4r3fpmlb 18 7 classified classify VBN cord-017784-4r3fpmlb 18 8 as as IN cord-017784-4r3fpmlb 18 9 either either DT cord-017784-4r3fpmlb 18 10 hypoxemic hypoxemic NNP cord-017784-4r3fpmlb 18 11 or or CC cord-017784-4r3fpmlb 18 12 hypercapnic hypercapnic NNP cord-017784-4r3fpmlb 18 13 . . . cord-017784-4r3fpmlb 19 1 Hypoxemic hypoxemic JJ cord-017784-4r3fpmlb 19 2 respiratory respiratory JJ cord-017784-4r3fpmlb 19 3 failure failure NN cord-017784-4r3fpmlb 19 4 ( ( -LRB- cord-017784-4r3fpmlb 19 5 type type NN cord-017784-4r3fpmlb 19 6 I i NN cord-017784-4r3fpmlb 19 7 ) ) -RRB- cord-017784-4r3fpmlb 19 8 is be VBZ cord-017784-4r3fpmlb 19 9 characterized characterize VBN cord-017784-4r3fpmlb 19 10 by by IN cord-017784-4r3fpmlb 19 11 an an DT cord-017784-4r3fpmlb 19 12 arterial arterial JJ cord-017784-4r3fpmlb 19 13 oxygen oxygen NN cord-017784-4r3fpmlb 19 14 tension tension NN cord-017784-4r3fpmlb 19 15 ( ( -LRB- cord-017784-4r3fpmlb 19 16 PaO PaO NNP cord-017784-4r3fpmlb 19 17 2 2 CD cord-017784-4r3fpmlb 19 18 ) ) -RRB- cord-017784-4r3fpmlb 20 1 lower low JJR cord-017784-4r3fpmlb 20 2 than than IN cord-017784-4r3fpmlb 20 3 60 60 CD cord-017784-4r3fpmlb 20 4 mm mm NN cord-017784-4r3fpmlb 20 5 Hg hg NN cord-017784-4r3fpmlb 20 6 with with IN cord-017784-4r3fpmlb 20 7 a a DT cord-017784-4r3fpmlb 20 8 normal normal JJ cord-017784-4r3fpmlb 20 9 or or CC cord-017784-4r3fpmlb 20 10 low low JJ cord-017784-4r3fpmlb 20 11 arterial arterial JJ cord-017784-4r3fpmlb 20 12 carbon carbon NN cord-017784-4r3fpmlb 20 13 dioxide dioxide NN cord-017784-4r3fpmlb 20 14 tension tension NN cord-017784-4r3fpmlb 20 15 ( ( -LRB- cord-017784-4r3fpmlb 20 16 PaCO paco NN cord-017784-4r3fpmlb 20 17 2 2 CD cord-017784-4r3fpmlb 20 18 ) ) -RRB- cord-017784-4r3fpmlb 20 19 . . . cord-017784-4r3fpmlb 21 1 This this DT cord-017784-4r3fpmlb 21 2 is be VBZ cord-017784-4r3fpmlb 21 3 the the DT cord-017784-4r3fpmlb 21 4 most most RBS cord-017784-4r3fpmlb 21 5 common common JJ cord-017784-4r3fpmlb 21 6 form form NN cord-017784-4r3fpmlb 21 7 of of IN cord-017784-4r3fpmlb 21 8 respiratory respiratory JJ cord-017784-4r3fpmlb 21 9 failure failure NN cord-017784-4r3fpmlb 21 10 , , , cord-017784-4r3fpmlb 21 11 and and CC cord-017784-4r3fpmlb 21 12 it -PRON- PRP cord-017784-4r3fpmlb 21 13 can can MD cord-017784-4r3fpmlb 21 14 be be VB cord-017784-4r3fpmlb 21 15 associated associate VBN cord-017784-4r3fpmlb 21 16 with with IN cord-017784-4r3fpmlb 21 17 virtually virtually RB cord-017784-4r3fpmlb 21 18 all all DT cord-017784-4r3fpmlb 21 19 acute acute JJ cord-017784-4r3fpmlb 21 20 diseases disease NNS cord-017784-4r3fpmlb 21 21 of of IN cord-017784-4r3fpmlb 21 22 the the DT cord-017784-4r3fpmlb 21 23 lung lung NN cord-017784-4r3fpmlb 21 24 , , , cord-017784-4r3fpmlb 21 25 which which WDT cord-017784-4r3fpmlb 21 26 generally generally RB cord-017784-4r3fpmlb 21 27 involve involve VBP cord-017784-4r3fpmlb 21 28 fluid fluid NN cord-017784-4r3fpmlb 21 29 filling filling NN cord-017784-4r3fpmlb 21 30 or or CC cord-017784-4r3fpmlb 21 31 collapse collapse NN cord-017784-4r3fpmlb 21 32 of of IN cord-017784-4r3fpmlb 21 33 alveolar alveolar JJ cord-017784-4r3fpmlb 21 34 units unit NNS cord-017784-4r3fpmlb 21 35 . . . cord-017784-4r3fpmlb 22 1 The the DT cord-017784-4r3fpmlb 22 2 four four CD cord-017784-4r3fpmlb 22 3 pathophysiological pathophysiological JJ cord-017784-4r3fpmlb 22 4 mechanisms mechanism NNS cord-017784-4r3fpmlb 22 5 related relate VBN cord-017784-4r3fpmlb 22 6 to to IN cord-017784-4r3fpmlb 22 7 hypoxemic hypoxemic NNP cord-017784-4r3fpmlb 22 8 ARF ARF NNP cord-017784-4r3fpmlb 22 9 are be VBP cord-017784-4r3fpmlb 22 10 [ [ -LRB- cord-017784-4r3fpmlb 22 11 3 3 CD cord-017784-4r3fpmlb 22 12 , , , cord-017784-4r3fpmlb 22 13 4 4 CD cord-017784-4r3fpmlb 22 14 ] ] -RRB- cord-017784-4r3fpmlb 22 15 : : : cord-017784-4r3fpmlb 23 1 1 1 LS cord-017784-4r3fpmlb 23 2 . . . cord-017784-4r3fpmlb 24 1 Ventilation ventilation NN cord-017784-4r3fpmlb 24 2 / / SYM cord-017784-4r3fpmlb 24 3 perfusion perfusion NN cord-017784-4r3fpmlb 24 4 inequality inequality NN cord-017784-4r3fpmlb 24 5 which which WDT cord-017784-4r3fpmlb 24 6 is be VBZ cord-017784-4r3fpmlb 24 7 the the DT cord-017784-4r3fpmlb 24 8 main main JJ cord-017784-4r3fpmlb 24 9 mechanisms mechanism NNS cord-017784-4r3fpmlb 24 10 in in IN cord-017784-4r3fpmlb 24 11 an an DT cord-017784-4r3fpmlb 24 12 emergency emergency NN cord-017784-4r3fpmlb 24 13 setting set VBG cord-017784-4r3fpmlb 24 14 ( ( -LRB- cord-017784-4r3fpmlb 24 15 congestive congestive JJ cord-017784-4r3fpmlb 24 16 heart heart NN cord-017784-4r3fpmlb 24 17 failure failure NN cord-017784-4r3fpmlb 24 18 or or CC cord-017784-4r3fpmlb 24 19 pneumonia pneumonia NN cord-017784-4r3fpmlb 24 20 ) ) -RRB- cord-017784-4r3fpmlb 24 21 2 2 CD cord-017784-4r3fpmlb 24 22 . . . cord-017784-4r3fpmlb 25 1 Increased increased JJ cord-017784-4r3fpmlb 25 2 shunt shunt NN cord-017784-4r3fpmlb 25 3 ( ( -LRB- cord-017784-4r3fpmlb 25 4 acute acute JJ cord-017784-4r3fpmlb 25 5 respiratory respiratory JJ cord-017784-4r3fpmlb 25 6 distress distress NN cord-017784-4r3fpmlb 25 7 syndrome syndrome NN cord-017784-4r3fpmlb 25 8 ) ) -RRB- cord-017784-4r3fpmlb 25 9 3 3 CD cord-017784-4r3fpmlb 25 10 . . . cord-017784-4r3fpmlb 26 1 Alveolar alveolar JJ cord-017784-4r3fpmlb 26 2 hypoventilation hypoventilation NN cord-017784-4r3fpmlb 26 3 ( ( -LRB- cord-017784-4r3fpmlb 26 4 chronic chronic JJ cord-017784-4r3fpmlb 26 5 obstructive obstructive JJ cord-017784-4r3fpmlb 26 6 pulmonary pulmonary JJ cord-017784-4r3fpmlb 26 7 disease disease NN cord-017784-4r3fpmlb 26 8 ) ) -RRB- cord-017784-4r3fpmlb 26 9 4 4 CD cord-017784-4r3fpmlb 26 10 . . . cord-017784-4r3fpmlb 27 1 Diffusion diffusion NN cord-017784-4r3fpmlb 27 2 impairment impairment NN cord-017784-4r3fpmlb 27 3 ( ( -LRB- cord-017784-4r3fpmlb 27 4 pulmonary pulmonary JJ cord-017784-4r3fpmlb 27 5 fibrosis fibrosis NN cord-017784-4r3fpmlb 27 6 ) ) -RRB- cord-017784-4r3fpmlb 28 1 Hypercapnic Hypercapnic NNP cord-017784-4r3fpmlb 28 2 respiratory respiratory JJ cord-017784-4r3fpmlb 28 3 failure failure NN cord-017784-4r3fpmlb 28 4 ( ( -LRB- cord-017784-4r3fpmlb 28 5 type type NN cord-017784-4r3fpmlb 28 6 II II NNP cord-017784-4r3fpmlb 28 7 ) ) -RRB- cord-017784-4r3fpmlb 28 8 is be VBZ cord-017784-4r3fpmlb 28 9 characterized characterize VBN cord-017784-4r3fpmlb 28 10 by by IN cord-017784-4r3fpmlb 28 11 a a DT cord-017784-4r3fpmlb 28 12 PaCO paco NN cord-017784-4r3fpmlb 28 13 2 2 CD cord-017784-4r3fpmlb 28 14 higher high JJR cord-017784-4r3fpmlb 28 15 than than IN cord-017784-4r3fpmlb 28 16 45 45 CD cord-017784-4r3fpmlb 28 17 mmHg mmHg NNS cord-017784-4r3fpmlb 28 18 . . . cord-017784-4r3fpmlb 28 19 Hypoxemia Hypoxemia NNP cord-017784-4r3fpmlb 28 20 is be VBZ cord-017784-4r3fpmlb 28 21 common common JJ cord-017784-4r3fpmlb 28 22 in in IN cord-017784-4r3fpmlb 28 23 patients patient NNS cord-017784-4r3fpmlb 28 24 with with IN cord-017784-4r3fpmlb 28 25 hypercapnic hypercapnic NNP cord-017784-4r3fpmlb 28 26 respiratory respiratory JJ cord-017784-4r3fpmlb 28 27 failure failure NN cord-017784-4r3fpmlb 28 28 who who WP cord-017784-4r3fpmlb 28 29 are be VBP cord-017784-4r3fpmlb 28 30 breathing breathe VBG cord-017784-4r3fpmlb 28 31 room room NN cord-017784-4r3fpmlb 28 32 air air NN cord-017784-4r3fpmlb 28 33 . . . cord-017784-4r3fpmlb 29 1 Common common JJ cord-017784-4r3fpmlb 29 2 etiologies etiology NNS cord-017784-4r3fpmlb 29 3 include include VBP cord-017784-4r3fpmlb 29 4 drug drug NN cord-017784-4r3fpmlb 29 5 overdose overdose NN cord-017784-4r3fpmlb 29 6 , , , cord-017784-4r3fpmlb 29 7 neuromuscular neuromuscular JJ cord-017784-4r3fpmlb 29 8 disease disease NN cord-017784-4r3fpmlb 29 9 , , , cord-017784-4r3fpmlb 29 10 chest chest NN cord-017784-4r3fpmlb 29 11 wall wall NN cord-017784-4r3fpmlb 29 12 abnormalities abnormality NNS cord-017784-4r3fpmlb 29 13 , , , cord-017784-4r3fpmlb 29 14 and and CC cord-017784-4r3fpmlb 29 15 severe severe JJ cord-017784-4r3fpmlb 29 16 airway airway NN cord-017784-4r3fpmlb 29 17 disorders disorder NNS cord-017784-4r3fpmlb 29 18 ( ( -LRB- cord-017784-4r3fpmlb 29 19 e.g. e.g. RB cord-017784-4r3fpmlb 29 20 , , , cord-017784-4r3fpmlb 29 21 chronic chronic JJ cord-017784-4r3fpmlb 29 22 obstructive obstructive JJ cord-017784-4r3fpmlb 29 23 pulmonary pulmonary JJ cord-017784-4r3fpmlb 29 24 disease disease NN cord-017784-4r3fpmlb 29 25 ) ) -RRB- cord-017784-4r3fpmlb 29 26 . . . cord-017784-4r3fpmlb 30 1 In in IN cord-017784-4r3fpmlb 30 2 case case NN cord-017784-4r3fpmlb 30 3 of of IN cord-017784-4r3fpmlb 30 4 a a DT cord-017784-4r3fpmlb 30 5 COPD COPD NNP cord-017784-4r3fpmlb 30 6 exacerbation exacerbation NN cord-017784-4r3fpmlb 30 7 , , , cord-017784-4r3fpmlb 30 8 an an DT cord-017784-4r3fpmlb 30 9 acute acute JJ cord-017784-4r3fpmlb 30 10 inflammation inflammation NN cord-017784-4r3fpmlb 30 11 in in IN cord-017784-4r3fpmlb 30 12 the the DT cord-017784-4r3fpmlb 30 13 airways airways NNP cord-017784-4r3fpmlb 30 14 increases increase VBZ cord-017784-4r3fpmlb 30 15 resistance resistance NN cord-017784-4r3fpmlb 30 16 to to IN cord-017784-4r3fpmlb 30 17 air air NN cord-017784-4r3fpmlb 30 18 flow flow NN cord-017784-4r3fpmlb 30 19 with with IN cord-017784-4r3fpmlb 30 20 consequent consequent JJ cord-017784-4r3fpmlb 30 21 air air NN cord-017784-4r3fpmlb 30 22 trapping trapping NN cord-017784-4r3fpmlb 30 23 . . . cord-017784-4r3fpmlb 31 1 Increased increase VBN cord-017784-4r3fpmlb 31 2 resistance resistance NN cord-017784-4r3fpmlb 31 3 and and CC cord-017784-4r3fpmlb 31 4 elastic elastic JJ cord-017784-4r3fpmlb 31 5 load load NN cord-017784-4r3fpmlb 31 6 due due JJ cord-017784-4r3fpmlb 31 7 to to IN cord-017784-4r3fpmlb 31 8 air air NN cord-017784-4r3fpmlb 31 9 trapping trapping NN cord-017784-4r3fpmlb 31 10 place place NN cord-017784-4r3fpmlb 31 11 respiratory respiratory JJ cord-017784-4r3fpmlb 31 12 muscles muscle NNS cord-017784-4r3fpmlb 31 13 at at IN cord-017784-4r3fpmlb 31 14 a a DT cord-017784-4r3fpmlb 31 15 mechanical mechanical JJ cord-017784-4r3fpmlb 31 16 disadvantage disadvantage NN cord-017784-4r3fpmlb 31 17 and and CC cord-017784-4r3fpmlb 31 18 increases increase VBZ cord-017784-4r3fpmlb 31 19 the the DT cord-017784-4r3fpmlb 31 20 work work NN cord-017784-4r3fpmlb 31 21 of of IN cord-017784-4r3fpmlb 31 22 breathing breathing NN cord-017784-4r3fpmlb 31 23 and and CC cord-017784-4r3fpmlb 31 24 leads lead VBZ cord-017784-4r3fpmlb 31 25 to to IN cord-017784-4r3fpmlb 31 26 ARF ARF NNP cord-017784-4r3fpmlb 31 27 . . . cord-017784-4r3fpmlb 32 1 Infectious infectious JJ cord-017784-4r3fpmlb 32 2 factor factor NN cord-017784-4r3fpmlb 32 3 such such JJ cord-017784-4r3fpmlb 32 4 as as IN cord-017784-4r3fpmlb 32 5 pneumonia pneumonia NN cord-017784-4r3fpmlb 32 6 with with IN cord-017784-4r3fpmlb 32 7 / / SYM cord-017784-4r3fpmlb 32 8 without without IN cord-017784-4r3fpmlb 32 9 sepsis sepsis NN cord-017784-4r3fpmlb 32 10 caused cause VBN cord-017784-4r3fpmlb 32 11 by by IN cord-017784-4r3fpmlb 32 12 a a DT cord-017784-4r3fpmlb 32 13 variety variety NN cord-017784-4r3fpmlb 32 14 of of IN cord-017784-4r3fpmlb 32 15 pathogens pathogen NNS cord-017784-4r3fpmlb 32 16 , , , cord-017784-4r3fpmlb 32 17 including include VBG cord-017784-4r3fpmlb 32 18 bacteria bacteria NNS cord-017784-4r3fpmlb 32 19 , , , cord-017784-4r3fpmlb 32 20 viruses virus NNS cord-017784-4r3fpmlb 32 21 , , , cord-017784-4r3fpmlb 32 22 malaria malaria NN cord-017784-4r3fpmlb 32 23 , , , cord-017784-4r3fpmlb 32 24 and and CC cord-017784-4r3fpmlb 32 25 fungal fungal NN cord-017784-4r3fpmlb 32 26 is be VBZ cord-017784-4r3fpmlb 32 27 the the DT cord-017784-4r3fpmlb 32 28 medical medical JJ cord-017784-4r3fpmlb 32 29 condition condition NN cord-017784-4r3fpmlb 32 30 that that WDT cord-017784-4r3fpmlb 32 31 is be VBZ cord-017784-4r3fpmlb 32 32 most most RBS cord-017784-4r3fpmlb 32 33 commonly commonly RB cord-017784-4r3fpmlb 32 34 associated associate VBN cord-017784-4r3fpmlb 32 35 with with IN cord-017784-4r3fpmlb 32 36 acute acute JJ cord-017784-4r3fpmlb 32 37 respiratory respiratory JJ cord-017784-4r3fpmlb 32 38 distress distress NN cord-017784-4r3fpmlb 32 39 syndrome syndrome NN cord-017784-4r3fpmlb 32 40 ( ( -LRB- cord-017784-4r3fpmlb 32 41 ARDS ARDS NNP cord-017784-4r3fpmlb 32 42 ) ) -RRB- cord-017784-4r3fpmlb 32 43 . . . cord-017784-4r3fpmlb 33 1 Sepsis sepsis NN cord-017784-4r3fpmlb 33 2 due due IN cord-017784-4r3fpmlb 33 3 to to IN cord-017784-4r3fpmlb 33 4 nonpulmonary nonpulmonary JJ cord-017784-4r3fpmlb 33 5 infections infection NNS cord-017784-4r3fpmlb 33 6 , , , cord-017784-4r3fpmlb 33 7 aspiration aspiration NN cord-017784-4r3fpmlb 33 8 of of IN cord-017784-4r3fpmlb 33 9 gastric gastric JJ cord-017784-4r3fpmlb 33 10 contents content NNS cord-017784-4r3fpmlb 33 11 , , , cord-017784-4r3fpmlb 33 12 and and CC cord-017784-4r3fpmlb 33 13 major major JJ cord-017784-4r3fpmlb 33 14 trauma trauma NN cord-017784-4r3fpmlb 33 15 with with IN cord-017784-4r3fpmlb 33 16 shock shock NN cord-017784-4r3fpmlb 33 17 also also RB cord-017784-4r3fpmlb 33 18 commonly commonly RB cord-017784-4r3fpmlb 33 19 precipitate precipitate VBP cord-017784-4r3fpmlb 33 20 the the DT cord-017784-4r3fpmlb 33 21 injury injury NN cord-017784-4r3fpmlb 33 22 [ [ -LRB- cord-017784-4r3fpmlb 33 23 5 5 CD cord-017784-4r3fpmlb 33 24 ] ] -RRB- cord-017784-4r3fpmlb 33 25 . . . cord-017784-4r3fpmlb 34 1 Since since IN cord-017784-4r3fpmlb 34 2 the the DT cord-017784-4r3fpmlb 34 3 same same JJ cord-017784-4r3fpmlb 34 4 kinds kind NNS cord-017784-4r3fpmlb 34 5 of of IN cord-017784-4r3fpmlb 34 6 immune immune JJ cord-017784-4r3fpmlb 34 7 cells cell NNS cord-017784-4r3fpmlb 34 8 and and CC cord-017784-4r3fpmlb 34 9 immune immune JJ cord-017784-4r3fpmlb 34 10 proteins protein NNS cord-017784-4r3fpmlb 34 11 , , , cord-017784-4r3fpmlb 34 12 including include VBG cord-017784-4r3fpmlb 34 13 immunoglobulins immunoglobulin NNS cord-017784-4r3fpmlb 34 14 and and CC cord-017784-4r3fpmlb 34 15 complements complement NNS cord-017784-4r3fpmlb 34 16 , , , cord-017784-4r3fpmlb 34 17 are be VBP cord-017784-4r3fpmlb 34 18 observed observe VBN cord-017784-4r3fpmlb 34 19 in in IN cord-017784-4r3fpmlb 34 20 the the DT cord-017784-4r3fpmlb 34 21 pathologic pathologic JJ cord-017784-4r3fpmlb 34 22 lesions lesion NNS cord-017784-4r3fpmlb 34 23 of of IN cord-017784-4r3fpmlb 34 24 pneumonia pneumonia NN cord-017784-4r3fpmlb 34 25 , , , cord-017784-4r3fpmlb 34 26 ARDS ARDS NNP cord-017784-4r3fpmlb 34 27 , , , cord-017784-4r3fpmlb 34 28 and and CC cord-017784-4r3fpmlb 34 29 other other JJ cord-017784-4r3fpmlb 34 30 organ organ NN cord-017784-4r3fpmlb 34 31 - - HYPH cord-017784-4r3fpmlb 34 32 specific specific JJ cord-017784-4r3fpmlb 34 33 pathologic pathologic JJ cord-017784-4r3fpmlb 34 34 lesions lesion NNS cord-017784-4r3fpmlb 34 35 , , , cord-017784-4r3fpmlb 34 36 it -PRON- PRP cord-017784-4r3fpmlb 34 37 may may MD cord-017784-4r3fpmlb 34 38 be be VB cord-017784-4r3fpmlb 34 39 a a DT cord-017784-4r3fpmlb 34 40 reasonable reasonable JJ cord-017784-4r3fpmlb 34 41 assumption assumption NN cord-017784-4r3fpmlb 34 42 that that IN cord-017784-4r3fpmlb 34 43 sepsis sepsis NN cord-017784-4r3fpmlb 34 44 and and CC cord-017784-4r3fpmlb 34 45 ARDS ARDS NNP cord-017784-4r3fpmlb 34 46 have have VBP cord-017784-4r3fpmlb 34 47 similar similar JJ cord-017784-4r3fpmlb 34 48 underlying underlying JJ cord-017784-4r3fpmlb 34 49 mechanisms mechanism NNS cord-017784-4r3fpmlb 34 50 , , , cord-017784-4r3fpmlb 34 51 characterized characterize VBN cord-017784-4r3fpmlb 34 52 by by IN cord-017784-4r3fpmlb 34 53 inflammation inflammation NN cord-017784-4r3fpmlb 34 54 and and CC cord-017784-4r3fpmlb 34 55 endothelial endothelial JJ cord-017784-4r3fpmlb 34 56 dysfunction dysfunction NN cord-017784-4r3fpmlb 34 57 [ [ -LRB- cord-017784-4r3fpmlb 34 58 6 6 CD cord-017784-4r3fpmlb 34 59 ] ] -RRB- cord-017784-4r3fpmlb 34 60 . . . cord-017784-4r3fpmlb 35 1 ARDS ARDS NNP cord-017784-4r3fpmlb 35 2 is be VBZ cord-017784-4r3fpmlb 35 3 a a DT cord-017784-4r3fpmlb 35 4 heterogeneous heterogeneous JJ cord-017784-4r3fpmlb 35 5 syndrome syndrome NN cord-017784-4r3fpmlb 35 6 characterized characterize VBN cord-017784-4r3fpmlb 35 7 by by IN cord-017784-4r3fpmlb 35 8 increased increase VBN cord-017784-4r3fpmlb 35 9 permeability permeability NN cord-017784-4r3fpmlb 35 10 of of IN cord-017784-4r3fpmlb 35 11 pulmonary pulmonary JJ cord-017784-4r3fpmlb 35 12 capillary capillary JJ cord-017784-4r3fpmlb 35 13 endothelial endothelial JJ cord-017784-4r3fpmlb 35 14 cells cell NNS cord-017784-4r3fpmlb 35 15 and and CC cord-017784-4r3fpmlb 35 16 alveolar alveolar JJ cord-017784-4r3fpmlb 35 17 epithelial epithelial JJ cord-017784-4r3fpmlb 35 18 cells cell NNS cord-017784-4r3fpmlb 35 19 , , , cord-017784-4r3fpmlb 35 20 leading lead VBG cord-017784-4r3fpmlb 35 21 to to IN cord-017784-4r3fpmlb 35 22 hypoxemia hypoxemia NN cord-017784-4r3fpmlb 35 23 that that WDT cord-017784-4r3fpmlb 35 24 is be VBZ cord-017784-4r3fpmlb 35 25 refractory refractory JJ cord-017784-4r3fpmlb 35 26 to to IN cord-017784-4r3fpmlb 35 27 usual usual JJ cord-017784-4r3fpmlb 35 28 oxygen oxygen NN cord-017784-4r3fpmlb 35 29 therapy therapy NN cord-017784-4r3fpmlb 35 30 [ [ -LRB- cord-017784-4r3fpmlb 35 31 7 7 CD cord-017784-4r3fpmlb 35 32 ] ] -RRB- cord-017784-4r3fpmlb 35 33 . . . cord-017784-4r3fpmlb 36 1 The the DT cord-017784-4r3fpmlb 36 2 severity severity NN cord-017784-4r3fpmlb 36 3 of of IN cord-017784-4r3fpmlb 36 4 ARDS ARDS NNP cord-017784-4r3fpmlb 36 5 is be VBZ cord-017784-4r3fpmlb 36 6 associated associate VBN cord-017784-4r3fpmlb 36 7 with with IN cord-017784-4r3fpmlb 36 8 poor poor JJ cord-017784-4r3fpmlb 36 9 prognosis prognosis NN cord-017784-4r3fpmlb 36 10 and and CC cord-017784-4r3fpmlb 36 11 higher high JJR cord-017784-4r3fpmlb 36 12 mortality mortality NN cord-017784-4r3fpmlb 36 13 , , , cord-017784-4r3fpmlb 36 14 and and CC cord-017784-4r3fpmlb 36 15 , , , cord-017784-4r3fpmlb 36 16 by by IN cord-017784-4r3fpmlb 36 17 the the DT cord-017784-4r3fpmlb 36 18 Berlin Berlin NNP cord-017784-4r3fpmlb 36 19 definition definition NN cord-017784-4r3fpmlb 36 20 , , , cord-017784-4r3fpmlb 36 21 diagnostic diagnostic JJ cord-017784-4r3fpmlb 36 22 hypoxemia hypoxemia NN cord-017784-4r3fpmlb 36 23 is be VBZ cord-017784-4r3fpmlb 36 24 defined define VBN cord-017784-4r3fpmlb 36 25 as as IN cord-017784-4r3fpmlb 36 26 decreased decrease VBN cord-017784-4r3fpmlb 36 27 arterial arterial JJ cord-017784-4r3fpmlb 36 28 PaO pao JJ cord-017784-4r3fpmlb 36 29 2 2 CD cord-017784-4r3fpmlb 36 30 /FiO /fio SYM cord-017784-4r3fpmlb 36 31 2 2 CD cord-017784-4r3fpmlb 36 32 ratio ratio NN cord-017784-4r3fpmlb 36 33 with with IN cord-017784-4r3fpmlb 36 34 parameters parameter NNS cord-017784-4r3fpmlb 36 35 of of IN cord-017784-4r3fpmlb 36 36 201 201 CD cord-017784-4r3fpmlb 36 37 - - SYM cord-017784-4r3fpmlb 36 38 300 300 CD cord-017784-4r3fpmlb 36 39 mmHg mmHg NNS cord-017784-4r3fpmlb 36 40 for for IN cord-017784-4r3fpmlb 36 41 mild mild JJ cord-017784-4r3fpmlb 36 42 ARDS ARDS NNP cord-017784-4r3fpmlb 36 43 , , , cord-017784-4r3fpmlb 36 44 101 101 CD cord-017784-4r3fpmlb 36 45 - - SYM cord-017784-4r3fpmlb 36 46 200 200 CD cord-017784-4r3fpmlb 36 47 mmHg mmHg NNS cord-017784-4r3fpmlb 36 48 for for IN cord-017784-4r3fpmlb 36 49 moderate moderate JJ cord-017784-4r3fpmlb 36 50 ARDS ARDS NNP cord-017784-4r3fpmlb 36 51 , , , cord-017784-4r3fpmlb 36 52 and and CC cord-017784-4r3fpmlb 36 53 < < XX cord-017784-4r3fpmlb 36 54 100 100 CD cord-017784-4r3fpmlb 36 55 mmHg mmHg NNS cord-017784-4r3fpmlb 36 56 for for IN cord-017784-4r3fpmlb 36 57 severe severe JJ cord-017784-4r3fpmlb 36 58 ARDS ARDS NNP cord-017784-4r3fpmlb 36 59 [ [ -LRB- cord-017784-4r3fpmlb 36 60 8 8 CD cord-017784-4r3fpmlb 36 61 ] ] -RRB- cord-017784-4r3fpmlb 36 62 . . . cord-017784-4r3fpmlb 37 1 Considering consider VBG cord-017784-4r3fpmlb 37 2 the the DT cord-017784-4r3fpmlb 37 3 immunopathogenesis immunopathogenesis NN cord-017784-4r3fpmlb 37 4 of of IN cord-017784-4r3fpmlb 37 5 pneumonia pneumonia NN cord-017784-4r3fpmlb 37 6 , , , cord-017784-4r3fpmlb 37 7 sepsis sepsis NN cord-017784-4r3fpmlb 37 8 , , , cord-017784-4r3fpmlb 37 9 and and CC cord-017784-4r3fpmlb 37 10 ARDS ARDS NNP cord-017784-4r3fpmlb 37 11 , , , cord-017784-4r3fpmlb 37 12 early early JJ cord-017784-4r3fpmlb 37 13 and and CC cord-017784-4r3fpmlb 37 14 appropriate appropriate JJ cord-017784-4r3fpmlb 37 15 antimicrobial antimicrobial JJ cord-017784-4r3fpmlb 37 16 therapy therapy NN cord-017784-4r3fpmlb 37 17 is be VBZ cord-017784-4r3fpmlb 37 18 critical critical JJ cord-017784-4r3fpmlb 37 19 to to TO cord-017784-4r3fpmlb 37 20 reduce reduce VB cord-017784-4r3fpmlb 37 21 the the DT cord-017784-4r3fpmlb 37 22 number number NN cord-017784-4r3fpmlb 37 23 of of IN cord-017784-4r3fpmlb 37 24 pathogens pathogen NNS cord-017784-4r3fpmlb 37 25 and and CC cord-017784-4r3fpmlb 37 26 pathogen pathogen NN cord-017784-4r3fpmlb 37 27 - - HYPH cord-017784-4r3fpmlb 37 28 originated originate VBN cord-017784-4r3fpmlb 37 29 substances substance NNS cord-017784-4r3fpmlb 37 30 , , , cord-017784-4r3fpmlb 37 31 thereby thereby RB cord-017784-4r3fpmlb 37 32 inducing induce VBG cord-017784-4r3fpmlb 37 33 early early JJ cord-017784-4r3fpmlb 37 34 recovery recovery NN cord-017784-4r3fpmlb 37 35 from from IN cord-017784-4r3fpmlb 37 36 the the DT cord-017784-4r3fpmlb 37 37 disease disease NN cord-017784-4r3fpmlb 37 38 and and CC cord-017784-4r3fpmlb 37 39 better well JJR cord-017784-4r3fpmlb 37 40 outcome outcome NN cord-017784-4r3fpmlb 37 41 . . . cord-017784-4r3fpmlb 38 1 Similarly similarly RB cord-017784-4r3fpmlb 38 2 , , , cord-017784-4r3fpmlb 38 3 although although IN cord-017784-4r3fpmlb 38 4 the the DT cord-017784-4r3fpmlb 38 5 knowledge knowledge NN cord-017784-4r3fpmlb 38 6 about about IN cord-017784-4r3fpmlb 38 7 the the DT cord-017784-4r3fpmlb 38 8 effectiveness effectiveness NN cord-017784-4r3fpmlb 38 9 of of IN cord-017784-4r3fpmlb 38 10 antibiotics antibiotic NNS cord-017784-4r3fpmlb 38 11 in in IN cord-017784-4r3fpmlb 38 12 the the DT cord-017784-4r3fpmlb 38 13 management management NN cord-017784-4r3fpmlb 38 14 of of IN cord-017784-4r3fpmlb 38 15 acute acute JJ cord-017784-4r3fpmlb 38 16 exacerbations exacerbation NNS cord-017784-4r3fpmlb 38 17 of of IN cord-017784-4r3fpmlb 38 18 COPD COPD NNP cord-017784-4r3fpmlb 38 19 remains remain VBZ cord-017784-4r3fpmlb 38 20 limited limit VBN cord-017784-4r3fpmlb 38 21 by by IN cord-017784-4r3fpmlb 38 22 the the DT cord-017784-4r3fpmlb 38 23 lack lack NN cord-017784-4r3fpmlb 38 24 of of IN cord-017784-4r3fpmlb 38 25 strong strong JJ cord-017784-4r3fpmlb 38 26 evidence evidence NN cord-017784-4r3fpmlb 38 27 , , , cord-017784-4r3fpmlb 38 28 studies study NNS cord-017784-4r3fpmlb 38 29 show show VBP cord-017784-4r3fpmlb 38 30 that that IN cord-017784-4r3fpmlb 38 31 early early JJ cord-017784-4r3fpmlb 38 32 antibiotic antibiotic JJ cord-017784-4r3fpmlb 38 33 administration administration NN cord-017784-4r3fpmlb 38 34 is be VBZ cord-017784-4r3fpmlb 38 35 associated associate VBN cord-017784-4r3fpmlb 38 36 with with IN cord-017784-4r3fpmlb 38 37 improved improved JJ cord-017784-4r3fpmlb 38 38 outcomes outcome NNS cord-017784-4r3fpmlb 38 39 among among IN cord-017784-4r3fpmlb 38 40 patients patient NNS cord-017784-4r3fpmlb 38 41 hospitalized hospitalize VBN cord-017784-4r3fpmlb 38 42 for for IN cord-017784-4r3fpmlb 38 43 acute acute JJ cord-017784-4r3fpmlb 38 44 exacerbations exacerbation NNS cord-017784-4r3fpmlb 38 45 of of IN cord-017784-4r3fpmlb 38 46 COPD COPD NNP cord-017784-4r3fpmlb 38 47 [ [ -LRB- cord-017784-4r3fpmlb 38 48 9 9 CD cord-017784-4r3fpmlb 38 49 ] ] -RRB- cord-017784-4r3fpmlb 38 50 . . . cord-017784-4r3fpmlb 39 1 Furthermore furthermore RB cord-017784-4r3fpmlb 39 2 inadequate inadequate JJ cord-017784-4r3fpmlb 39 3 antibiotic antibiotic JJ cord-017784-4r3fpmlb 39 4 therapy therapy NN cord-017784-4r3fpmlb 39 5 , , , cord-017784-4r3fpmlb 39 6 which which WDT cord-017784-4r3fpmlb 39 7 through through IN cord-017784-4r3fpmlb 39 8 incomplete incomplete JJ cord-017784-4r3fpmlb 39 9 resolution resolution NN cord-017784-4r3fpmlb 39 10 of of IN cord-017784-4r3fpmlb 39 11 the the DT cord-017784-4r3fpmlb 39 12 initial initial JJ cord-017784-4r3fpmlb 39 13 exacerbation exacerbation NN cord-017784-4r3fpmlb 39 14 and and CC cord-017784-4r3fpmlb 39 15 persistent persistent JJ cord-017784-4r3fpmlb 39 16 bacterial bacterial JJ cord-017784-4r3fpmlb 39 17 infection infection NN cord-017784-4r3fpmlb 39 18 , , , cord-017784-4r3fpmlb 39 19 is be VBZ cord-017784-4r3fpmlb 39 20 likely likely JJ cord-017784-4r3fpmlb 39 21 to to TO cord-017784-4r3fpmlb 39 22 influence influence VB cord-017784-4r3fpmlb 39 23 the the DT cord-017784-4r3fpmlb 39 24 risk risk NN cord-017784-4r3fpmlb 39 25 of of IN cord-017784-4r3fpmlb 39 26 relapse relapse NN cord-017784-4r3fpmlb 39 27 . . . cord-017784-4r3fpmlb 40 1 Exacerbations exacerbation NNS cord-017784-4r3fpmlb 40 2 of of IN cord-017784-4r3fpmlb 40 3 chronic chronic JJ cord-017784-4r3fpmlb 40 4 obstructive obstructive JJ cord-017784-4r3fpmlb 40 5 pulmonary pulmonary JJ cord-017784-4r3fpmlb 40 6 disease disease NN cord-017784-4r3fpmlb 40 7 ( ( -LRB- cord-017784-4r3fpmlb 40 8 COPD COPD NNP cord-017784-4r3fpmlb 40 9 ) ) -RRB- cord-017784-4r3fpmlb 40 10 are be VBP cord-017784-4r3fpmlb 40 11 defined define VBN cord-017784-4r3fpmlb 40 12 as as IN cord-017784-4r3fpmlb 40 13 sustained sustain VBN cord-017784-4r3fpmlb 40 14 worsening worsen VBG cord-017784-4r3fpmlb 40 15 of of IN cord-017784-4r3fpmlb 40 16 a a DT cord-017784-4r3fpmlb 40 17 patient patient NN cord-017784-4r3fpmlb 40 18 's 's POS cord-017784-4r3fpmlb 40 19 condition condition NN cord-017784-4r3fpmlb 40 20 beyond beyond IN cord-017784-4r3fpmlb 40 21 normal normal JJ cord-017784-4r3fpmlb 40 22 day day NN cord-017784-4r3fpmlb 40 23 - - HYPH cord-017784-4r3fpmlb 40 24 to to IN cord-017784-4r3fpmlb 40 25 - - HYPH cord-017784-4r3fpmlb 40 26 day day NN cord-017784-4r3fpmlb 40 27 variations variation NNS cord-017784-4r3fpmlb 40 28 that that WDT cord-017784-4r3fpmlb 40 29 is be VBZ cord-017784-4r3fpmlb 40 30 acute acute JJ cord-017784-4r3fpmlb 40 31 in in IN cord-017784-4r3fpmlb 40 32 onset onset NN cord-017784-4r3fpmlb 40 33 , , , cord-017784-4r3fpmlb 40 34 and and CC cord-017784-4r3fpmlb 40 35 that that DT cord-017784-4r3fpmlb 40 36 may may MD cord-017784-4r3fpmlb 40 37 also also RB cord-017784-4r3fpmlb 40 38 require require VB cord-017784-4r3fpmlb 40 39 a a DT cord-017784-4r3fpmlb 40 40 change change NN cord-017784-4r3fpmlb 40 41 in in IN cord-017784-4r3fpmlb 40 42 medication medication NN cord-017784-4r3fpmlb 40 43 and/or and/or CC cord-017784-4r3fpmlb 40 44 hospitalization hospitalization NN cord-017784-4r3fpmlb 40 45 [ [ -LRB- cord-017784-4r3fpmlb 40 46 10 10 CD cord-017784-4r3fpmlb 40 47 ] ] -RRB- cord-017784-4r3fpmlb 40 48 . . . cord-017784-4r3fpmlb 41 1 An an DT cord-017784-4r3fpmlb 41 2 acute acute JJ cord-017784-4r3fpmlb 41 3 COPD COPD NNP cord-017784-4r3fpmlb 41 4 exacerbation exacerbation NN cord-017784-4r3fpmlb 41 5 can can MD cord-017784-4r3fpmlb 41 6 be be VB cord-017784-4r3fpmlb 41 7 viewed view VBN cord-017784-4r3fpmlb 41 8 as as IN cord-017784-4r3fpmlb 41 9 an an DT cord-017784-4r3fpmlb 41 10 acute acute JJ cord-017784-4r3fpmlb 41 11 inflammatory inflammatory JJ cord-017784-4r3fpmlb 41 12 event event NN cord-017784-4r3fpmlb 41 13 superimposed superimpose VBN cord-017784-4r3fpmlb 41 14 on on IN cord-017784-4r3fpmlb 41 15 chronic chronic JJ cord-017784-4r3fpmlb 41 16 inflammation inflammation NN cord-017784-4r3fpmlb 41 17 associated associate VBN cord-017784-4r3fpmlb 41 18 with with IN cord-017784-4r3fpmlb 41 19 COPD COPD NNP cord-017784-4r3fpmlb 41 20 . . . cord-017784-4r3fpmlb 42 1 Most Most JJS cord-017784-4r3fpmlb 42 2 AECOPD AECOPD NNS cord-017784-4r3fpmlb 42 3 may may MD cord-017784-4r3fpmlb 42 4 be be VB cord-017784-4r3fpmlb 42 5 due due JJ cord-017784-4r3fpmlb 42 6 to to IN cord-017784-4r3fpmlb 42 7 viral viral JJ cord-017784-4r3fpmlb 42 8 infection infection NN cord-017784-4r3fpmlb 42 9 or or CC cord-017784-4r3fpmlb 42 10 bacterial bacterial JJ cord-017784-4r3fpmlb 42 11 infection infection NN cord-017784-4r3fpmlb 42 12 ( ( -LRB- cord-017784-4r3fpmlb 42 13 50 50 CD cord-017784-4r3fpmlb 42 14 % % NN cord-017784-4r3fpmlb 42 15 ) ) -RRB- cord-017784-4r3fpmlb 42 16 , , , cord-017784-4r3fpmlb 42 17 but but CC cord-017784-4r3fpmlb 42 18 irritants irritant NNS cord-017784-4r3fpmlb 42 19 such such JJ cord-017784-4r3fpmlb 42 20 as as IN cord-017784-4r3fpmlb 42 21 smoke smoke NN cord-017784-4r3fpmlb 42 22 or or CC cord-017784-4r3fpmlb 42 23 environmental environmental JJ cord-017784-4r3fpmlb 42 24 factors factor NNS cord-017784-4r3fpmlb 42 25 such such JJ cord-017784-4r3fpmlb 42 26 as as IN cord-017784-4r3fpmlb 42 27 low low JJ cord-017784-4r3fpmlb 42 28 temperature temperature NN cord-017784-4r3fpmlb 42 29 and and CC cord-017784-4r3fpmlb 42 30 air air NN cord-017784-4r3fpmlb 42 31 pollution pollution NN cord-017784-4r3fpmlb 42 32 account account NN cord-017784-4r3fpmlb 42 33 for for IN cord-017784-4r3fpmlb 42 34 15 15 CD cord-017784-4r3fpmlb 42 35 - - SYM cord-017784-4r3fpmlb 42 36 20 20 CD cord-017784-4r3fpmlb 42 37 % % NN cord-017784-4r3fpmlb 42 38 of of IN cord-017784-4r3fpmlb 42 39 exacerbations exacerbation NNS cord-017784-4r3fpmlb 42 40 [ [ -LRB- cord-017784-4r3fpmlb 42 41 11 11 CD cord-017784-4r3fpmlb 42 42 ] ] -RRB- cord-017784-4r3fpmlb 42 43 . . . cord-017784-4r3fpmlb 43 1 In in IN cord-017784-4r3fpmlb 43 2 patients patient NNS cord-017784-4r3fpmlb 43 3 with with IN cord-017784-4r3fpmlb 43 4 mild mild JJ cord-017784-4r3fpmlb 43 5 disease disease NN cord-017784-4r3fpmlb 43 6 , , , cord-017784-4r3fpmlb 43 7 Streptococcus streptococcus NN cord-017784-4r3fpmlb 43 8 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 43 9 , , , cord-017784-4r3fpmlb 43 10 Haemophilus haemophilus JJ cord-017784-4r3fpmlb 43 11 influenzae influenzae NN cord-017784-4r3fpmlb 43 12 , , , cord-017784-4r3fpmlb 43 13 and and CC cord-017784-4r3fpmlb 43 14 Moraxella Moraxella NNP cord-017784-4r3fpmlb 43 15 catarrhalis catarrhalis NNP cord-017784-4r3fpmlb 43 16 are be VBP cord-017784-4r3fpmlb 43 17 the the DT cord-017784-4r3fpmlb 43 18 predominant predominant JJ cord-017784-4r3fpmlb 43 19 microorganisms microorganism NNS cord-017784-4r3fpmlb 43 20 , , , cord-017784-4r3fpmlb 43 21 whereas whereas IN cord-017784-4r3fpmlb 43 22 in in IN cord-017784-4r3fpmlb 43 23 patients patient NNS cord-017784-4r3fpmlb 43 24 with with IN cord-017784-4r3fpmlb 43 25 severe severe JJ cord-017784-4r3fpmlb 43 26 COPD COPD NNP cord-017784-4r3fpmlb 43 27 , , , cord-017784-4r3fpmlb 43 28 requiring require VBG cord-017784-4r3fpmlb 43 29 mechanical mechanical JJ cord-017784-4r3fpmlb 43 30 ventilation ventilation NN cord-017784-4r3fpmlb 43 31 , , , cord-017784-4r3fpmlb 43 32 levels level NNS cord-017784-4r3fpmlb 43 33 of of IN cord-017784-4r3fpmlb 43 34 these these DT cord-017784-4r3fpmlb 43 35 bacteria bacteria NNS cord-017784-4r3fpmlb 43 36 are be VBP cord-017784-4r3fpmlb 43 37 reduced reduce VBN cord-017784-4r3fpmlb 43 38 and and CC cord-017784-4r3fpmlb 43 39 other other JJ cord-017784-4r3fpmlb 43 40 microorganism microorganism NN cord-017784-4r3fpmlb 43 41 such such JJ cord-017784-4r3fpmlb 43 42 as as IN cord-017784-4r3fpmlb 43 43 Haemophilus haemophilus JJ cord-017784-4r3fpmlb 43 44 parainfluenzae parainfluenzae NNS cord-017784-4r3fpmlb 43 45 and and CC cord-017784-4r3fpmlb 43 46 Pseudomonas Pseudomonas NNP cord-017784-4r3fpmlb 43 47 aeruginosa aeruginosa NN cord-017784-4r3fpmlb 43 48 predominate predominate VBP cord-017784-4r3fpmlb 43 49 . . . cord-017784-4r3fpmlb 44 1 It -PRON- PRP cord-017784-4r3fpmlb 44 2 has have VBZ cord-017784-4r3fpmlb 44 3 also also RB cord-017784-4r3fpmlb 44 4 been be VBN cord-017784-4r3fpmlb 44 5 observed observe VBN cord-017784-4r3fpmlb 44 6 that that IN cord-017784-4r3fpmlb 44 7 the the DT cord-017784-4r3fpmlb 44 8 severity severity NN cord-017784-4r3fpmlb 44 9 of of IN cord-017784-4r3fpmlb 44 10 lung lung NN cord-017784-4r3fpmlb 44 11 function function NN cord-017784-4r3fpmlb 44 12 , , , cord-017784-4r3fpmlb 44 13 measured measure VBN cord-017784-4r3fpmlb 44 14 by by IN cord-017784-4r3fpmlb 44 15 FEV1 FEV1 NNP cord-017784-4r3fpmlb 44 16 , , , cord-017784-4r3fpmlb 44 17 has have VBZ cord-017784-4r3fpmlb 44 18 an an DT cord-017784-4r3fpmlb 44 19 impact impact NN cord-017784-4r3fpmlb 44 20 on on IN cord-017784-4r3fpmlb 44 21 the the DT cord-017784-4r3fpmlb 44 22 microbiology microbiology NN cord-017784-4r3fpmlb 44 23 of of IN cord-017784-4r3fpmlb 44 24 exacerbation exacerbation NN cord-017784-4r3fpmlb 44 25 [ [ -LRB- cord-017784-4r3fpmlb 44 26 12 12 CD cord-017784-4r3fpmlb 44 27 ] ] -RRB- cord-017784-4r3fpmlb 44 28 . . . cord-017784-4r3fpmlb 45 1 Patients patient NNS cord-017784-4r3fpmlb 45 2 with with IN cord-017784-4r3fpmlb 45 3 increased increase VBN cord-017784-4r3fpmlb 45 4 airway airway JJ cord-017784-4r3fpmlb 45 5 obstruction obstruction NN cord-017784-4r3fpmlb 45 6 and and CC cord-017784-4r3fpmlb 45 7 frequent frequent JJ cord-017784-4r3fpmlb 45 8 exacerbations exacerbation NNS cord-017784-4r3fpmlb 45 9 , , , cord-017784-4r3fpmlb 45 10 the the DT cord-017784-4r3fpmlb 45 11 microbiology microbiology NN cord-017784-4r3fpmlb 45 12 of of IN cord-017784-4r3fpmlb 45 13 the the DT cord-017784-4r3fpmlb 45 14 exacerbations exacerbation NNS cord-017784-4r3fpmlb 45 15 is be VBZ cord-017784-4r3fpmlb 45 16 often often RB cord-017784-4r3fpmlb 45 17 more more RBR cord-017784-4r3fpmlb 45 18 complex complex JJ cord-017784-4r3fpmlb 45 19 , , , cord-017784-4r3fpmlb 45 20 with with IN cord-017784-4r3fpmlb 45 21 a a DT cord-017784-4r3fpmlb 45 22 predominance predominance NN cord-017784-4r3fpmlb 45 23 of of IN cord-017784-4r3fpmlb 45 24 Enterobacteriaceae Enterobacteriaceae NNP cord-017784-4r3fpmlb 45 25 and and CC cord-017784-4r3fpmlb 45 26 Pseudomonas Pseudomonas NNP cord-017784-4r3fpmlb 45 27 aeruginosa aeruginosa NN cord-017784-4r3fpmlb 45 28 . . . cord-017784-4r3fpmlb 46 1 The the DT cord-017784-4r3fpmlb 46 2 role role NN cord-017784-4r3fpmlb 46 3 of of IN cord-017784-4r3fpmlb 46 4 atypical atypical JJ cord-017784-4r3fpmlb 46 5 microorganisms microorganism NNS cord-017784-4r3fpmlb 46 6 is be VBZ cord-017784-4r3fpmlb 46 7 the the DT cord-017784-4r3fpmlb 46 8 subject subject NN cord-017784-4r3fpmlb 46 9 of of IN cord-017784-4r3fpmlb 46 10 debate debate NN cord-017784-4r3fpmlb 46 11 . . . cord-017784-4r3fpmlb 47 1 According accord VBG cord-017784-4r3fpmlb 47 2 to to IN cord-017784-4r3fpmlb 47 3 some some DT cord-017784-4r3fpmlb 47 4 authors author NNS cord-017784-4r3fpmlb 47 5 , , , cord-017784-4r3fpmlb 47 6 there there EX cord-017784-4r3fpmlb 47 7 is be VBZ cord-017784-4r3fpmlb 47 8 no no DT cord-017784-4r3fpmlb 47 9 association association NN cord-017784-4r3fpmlb 47 10 between between IN cord-017784-4r3fpmlb 47 11 the the DT cord-017784-4r3fpmlb 47 12 presence presence NN cord-017784-4r3fpmlb 47 13 of of IN cord-017784-4r3fpmlb 47 14 organisms organism NNS cord-017784-4r3fpmlb 47 15 such such JJ cord-017784-4r3fpmlb 47 16 as as IN cord-017784-4r3fpmlb 47 17 Chlamydia Chlamydia NNP cord-017784-4r3fpmlb 47 18 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 47 19 , , , cord-017784-4r3fpmlb 47 20 Legionella Legionella NNP cord-017784-4r3fpmlb 47 21 spp spp NNS cord-017784-4r3fpmlb 47 22 . . . cord-017784-4r3fpmlb 48 1 , , , cord-017784-4r3fpmlb 48 2 Mycoplasma mycoplasma NN cord-017784-4r3fpmlb 48 3 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 48 4 , , , cord-017784-4r3fpmlb 48 5 and and CC cord-017784-4r3fpmlb 48 6 AECOPD AECOPD NNP cord-017784-4r3fpmlb 48 7 [ [ -LRB- cord-017784-4r3fpmlb 48 8 13 13 CD cord-017784-4r3fpmlb 48 9 ] ] -RRB- cord-017784-4r3fpmlb 48 10 . . . cord-017784-4r3fpmlb 49 1 However however RB cord-017784-4r3fpmlb 49 2 , , , cord-017784-4r3fpmlb 49 3 in in IN cord-017784-4r3fpmlb 49 4 AECB AECB NNP cord-017784-4r3fpmlb 49 5 , , , cord-017784-4r3fpmlb 49 6 several several JJ cord-017784-4r3fpmlb 49 7 older old JJR cord-017784-4r3fpmlb 49 8 studies study NNS cord-017784-4r3fpmlb 49 9 and and CC cord-017784-4r3fpmlb 49 10 a a DT cord-017784-4r3fpmlb 49 11 few few JJ cord-017784-4r3fpmlb 49 12 recent recent JJ cord-017784-4r3fpmlb 49 13 studies study NNS cord-017784-4r3fpmlb 49 14 have have VBP cord-017784-4r3fpmlb 49 15 implicated implicate VBN cord-017784-4r3fpmlb 49 16 atypical atypical JJ cord-017784-4r3fpmlb 49 17 bacteria bacteria NNS cord-017784-4r3fpmlb 49 18 in in IN cord-017784-4r3fpmlb 49 19 only only RB cord-017784-4r3fpmlb 49 20 5 5 CD cord-017784-4r3fpmlb 49 21 - - SYM cord-017784-4r3fpmlb 49 22 10 10 CD cord-017784-4r3fpmlb 49 23 % % NN cord-017784-4r3fpmlb 49 24 of of IN cord-017784-4r3fpmlb 49 25 episodes episode NNS cord-017784-4r3fpmlb 49 26 [ [ -LRB- cord-017784-4r3fpmlb 49 27 14 14 CD cord-017784-4r3fpmlb 49 28 ] ] -RRB- cord-017784-4r3fpmlb 49 29 . . . cord-017784-4r3fpmlb 50 1 Although although IN cord-017784-4r3fpmlb 50 2 it -PRON- PRP cord-017784-4r3fpmlb 50 3 is be VBZ cord-017784-4r3fpmlb 50 4 difficult difficult JJ cord-017784-4r3fpmlb 50 5 to to TO cord-017784-4r3fpmlb 50 6 define define VB cord-017784-4r3fpmlb 50 7 precisely precisely RB cord-017784-4r3fpmlb 50 8 the the DT cord-017784-4r3fpmlb 50 9 proportion proportion NN cord-017784-4r3fpmlb 50 10 of of IN cord-017784-4r3fpmlb 50 11 exacerbations exacerbation NNS cord-017784-4r3fpmlb 50 12 caused cause VBN cord-017784-4r3fpmlb 50 13 by by IN cord-017784-4r3fpmlb 50 14 viruses virus NNS cord-017784-4r3fpmlb 50 15 , , , cord-017784-4r3fpmlb 50 16 they -PRON- PRP cord-017784-4r3fpmlb 50 17 are be VBP cord-017784-4r3fpmlb 50 18 often often RB cord-017784-4r3fpmlb 50 19 implicated implicate VBN cord-017784-4r3fpmlb 50 20 in in IN cord-017784-4r3fpmlb 50 21 AECOPD AECOPD NNP cord-017784-4r3fpmlb 50 22 ( ( -LRB- cord-017784-4r3fpmlb 50 23 up up IN cord-017784-4r3fpmlb 50 24 to to TO cord-017784-4r3fpmlb 50 25 30 30 CD cord-017784-4r3fpmlb 50 26 % % NN cord-017784-4r3fpmlb 50 27 of of IN cord-017784-4r3fpmlb 50 28 cases case NNS cord-017784-4r3fpmlb 50 29 ) ) -RRB- cord-017784-4r3fpmlb 51 1 [ [ -LRB- cord-017784-4r3fpmlb 51 2 15 15 CD cord-017784-4r3fpmlb 51 3 ] ] -RRB- cord-017784-4r3fpmlb 51 4 . . . cord-017784-4r3fpmlb 52 1 The the DT cord-017784-4r3fpmlb 52 2 most most RBS cord-017784-4r3fpmlb 52 3 common common JJ cord-017784-4r3fpmlb 52 4 viruses virus NNS cord-017784-4r3fpmlb 52 5 associated associate VBN cord-017784-4r3fpmlb 52 6 with with IN cord-017784-4r3fpmlb 52 7 exacerbations exacerbation NNS cord-017784-4r3fpmlb 52 8 of of IN cord-017784-4r3fpmlb 52 9 COPD COPD NNP cord-017784-4r3fpmlb 52 10 are be VBP cord-017784-4r3fpmlb 52 11 rhinoviruses rhinovirus NNS cord-017784-4r3fpmlb 52 12 , , , cord-017784-4r3fpmlb 52 13 but but CC cord-017784-4r3fpmlb 52 14 in in IN cord-017784-4r3fpmlb 52 15 more more RBR cord-017784-4r3fpmlb 52 16 severe severe JJ cord-017784-4r3fpmlb 52 17 exacerbations exacerbation NNS cord-017784-4r3fpmlb 52 18 requiring require VBG cord-017784-4r3fpmlb 52 19 hospitalization hospitalization NN cord-017784-4r3fpmlb 52 20 , , , cord-017784-4r3fpmlb 52 21 influenza influenza NN cord-017784-4r3fpmlb 52 22 virus virus NN cord-017784-4r3fpmlb 52 23 is be VBZ cord-017784-4r3fpmlb 52 24 more more RBR cord-017784-4r3fpmlb 52 25 common common JJ cord-017784-4r3fpmlb 52 26 . . . cord-017784-4r3fpmlb 53 1 Viral viral JJ cord-017784-4r3fpmlb 53 2 infection infection NN cord-017784-4r3fpmlb 53 3 may may MD cord-017784-4r3fpmlb 53 4 , , , cord-017784-4r3fpmlb 53 5 also also RB cord-017784-4r3fpmlb 53 6 , , , cord-017784-4r3fpmlb 53 7 facilitate facilitate VB cord-017784-4r3fpmlb 53 8 subsequent subsequent JJ cord-017784-4r3fpmlb 53 9 bacterial bacterial JJ cord-017784-4r3fpmlb 53 10 infection infection NN cord-017784-4r3fpmlb 53 11 or or CC cord-017784-4r3fpmlb 53 12 increase increase VB cord-017784-4r3fpmlb 53 13 the the DT cord-017784-4r3fpmlb 53 14 number number NN cord-017784-4r3fpmlb 53 15 of of IN cord-017784-4r3fpmlb 53 16 bacteria bacteria NNS cord-017784-4r3fpmlb 53 17 already already RB cord-017784-4r3fpmlb 53 18 present present JJ cord-017784-4r3fpmlb 53 19 in in IN cord-017784-4r3fpmlb 53 20 the the DT cord-017784-4r3fpmlb 53 21 lower low JJR cord-017784-4r3fpmlb 53 22 airways airway NNS cord-017784-4r3fpmlb 53 23 . . . cord-017784-4r3fpmlb 54 1 The the DT cord-017784-4r3fpmlb 54 2 use use NN cord-017784-4r3fpmlb 54 3 of of IN cord-017784-4r3fpmlb 54 4 antibiotics antibiotic NNS cord-017784-4r3fpmlb 54 5 in in IN cord-017784-4r3fpmlb 54 6 exacerbations exacerbation NNS cord-017784-4r3fpmlb 54 7 COPD COPD NNP cord-017784-4r3fpmlb 54 8 remains remain VBZ cord-017784-4r3fpmlb 54 9 controversial controversial JJ cord-017784-4r3fpmlb 54 10 ; ; : cord-017784-4r3fpmlb 54 11 therefore therefore RB cord-017784-4r3fpmlb 54 12 , , , cord-017784-4r3fpmlb 54 13 in in IN cord-017784-4r3fpmlb 54 14 the the DT cord-017784-4r3fpmlb 54 15 era era NN cord-017784-4r3fpmlb 54 16 of of IN cord-017784-4r3fpmlb 54 17 antibiotic antibiotic JJ cord-017784-4r3fpmlb 54 18 resistance resistance NN cord-017784-4r3fpmlb 54 19 , , , cord-017784-4r3fpmlb 54 20 the the DT cord-017784-4r3fpmlb 54 21 identification identification NN cord-017784-4r3fpmlb 54 22 of of IN cord-017784-4r3fpmlb 54 23 clinical clinical JJ cord-017784-4r3fpmlb 54 24 characteristics characteristic NNS cord-017784-4r3fpmlb 54 25 that that WDT cord-017784-4r3fpmlb 54 26 identify identify VBP cord-017784-4r3fpmlb 54 27 patients patient NNS cord-017784-4r3fpmlb 54 28 with with IN cord-017784-4r3fpmlb 54 29 AECOPD AECOPD NNP cord-017784-4r3fpmlb 54 30 that that WDT cord-017784-4r3fpmlb 54 31 can can MD cord-017784-4r3fpmlb 54 32 be be VB cord-017784-4r3fpmlb 54 33 safely safely RB cord-017784-4r3fpmlb 54 34 treated treat VBN cord-017784-4r3fpmlb 54 35 without without IN cord-017784-4r3fpmlb 54 36 antibiotics antibiotic NNS cord-017784-4r3fpmlb 54 37 is be VBZ cord-017784-4r3fpmlb 54 38 extremely extremely RB cord-017784-4r3fpmlb 54 39 important important JJ cord-017784-4r3fpmlb 54 40 . . . cord-017784-4r3fpmlb 55 1 There there EX cord-017784-4r3fpmlb 55 2 is be VBZ cord-017784-4r3fpmlb 55 3 evidence evidence NN cord-017784-4r3fpmlb 55 4 supporting support VBG cord-017784-4r3fpmlb 55 5 the the DT cord-017784-4r3fpmlb 55 6 use use NN cord-017784-4r3fpmlb 55 7 antibiotics antibiotic NNS cord-017784-4r3fpmlb 55 8 in in IN cord-017784-4r3fpmlb 55 9 exacerbations exacerbation NNS cord-017784-4r3fpmlb 55 10 when when WRB cord-017784-4r3fpmlb 55 11 patients patient NNS cord-017784-4r3fpmlb 55 12 have have VBP cord-017784-4r3fpmlb 55 13 clinical clinical JJ cord-017784-4r3fpmlb 55 14 signs sign NNS cord-017784-4r3fpmlb 55 15 of of IN cord-017784-4r3fpmlb 55 16 a a DT cord-017784-4r3fpmlb 55 17 bacterial bacterial JJ cord-017784-4r3fpmlb 55 18 infection infection NN cord-017784-4r3fpmlb 55 19 , , , cord-017784-4r3fpmlb 55 20 e.g. e.g. RB cord-017784-4r3fpmlb 55 21 , , , cord-017784-4r3fpmlb 55 22 increased increase VBN cord-017784-4r3fpmlb 55 23 sputum sputum NN cord-017784-4r3fpmlb 55 24 purulence purulence NN cord-017784-4r3fpmlb 55 25 , , , cord-017784-4r3fpmlb 55 26 especially especially RB cord-017784-4r3fpmlb 55 27 when when WRB cord-017784-4r3fpmlb 55 28 there there EX cord-017784-4r3fpmlb 55 29 are be VBP cord-017784-4r3fpmlb 55 30 changes change NNS cord-017784-4r3fpmlb 55 31 in in IN cord-017784-4r3fpmlb 55 32 the the DT cord-017784-4r3fpmlb 55 33 color color NN cord-017784-4r3fpmlb 55 34 of of IN cord-017784-4r3fpmlb 55 35 sputum sputum NN cord-017784-4r3fpmlb 55 36 [ [ -LRB- cord-017784-4r3fpmlb 55 37 16 16 CD cord-017784-4r3fpmlb 55 38 ] ] -RRB- cord-017784-4r3fpmlb 55 39 . . . cord-017784-4r3fpmlb 56 1 Antibiotics antibiotic NNS cord-017784-4r3fpmlb 56 2 are be VBP cord-017784-4r3fpmlb 56 3 also also RB cord-017784-4r3fpmlb 56 4 recommended recommend VBN cord-017784-4r3fpmlb 56 5 for for IN cord-017784-4r3fpmlb 56 6 patients patient NNS cord-017784-4r3fpmlb 56 7 with with IN cord-017784-4r3fpmlb 56 8 exacerbations exacerbation NNS cord-017784-4r3fpmlb 56 9 requiring require VBG cord-017784-4r3fpmlb 56 10 mechanical mechanical JJ cord-017784-4r3fpmlb 56 11 ventilation ventilation NN cord-017784-4r3fpmlb 56 12 , , , cord-017784-4r3fpmlb 56 13 as as IN cord-017784-4r3fpmlb 56 14 this this DT cord-017784-4r3fpmlb 56 15 has have VBZ cord-017784-4r3fpmlb 56 16 been be VBN cord-017784-4r3fpmlb 56 17 shown show VBN cord-017784-4r3fpmlb 56 18 significantly significantly RB cord-017784-4r3fpmlb 56 19 to to TO cord-017784-4r3fpmlb 56 20 reduce reduce VB cord-017784-4r3fpmlb 56 21 mortality mortality NN cord-017784-4r3fpmlb 56 22 and and CC cord-017784-4r3fpmlb 56 23 the the DT cord-017784-4r3fpmlb 56 24 risk risk NN cord-017784-4r3fpmlb 56 25 of of IN cord-017784-4r3fpmlb 56 26 secondary secondary JJ cord-017784-4r3fpmlb 56 27 pneumonia pneumonia NN cord-017784-4r3fpmlb 56 28 . . . cord-017784-4r3fpmlb 57 1 In in IN cord-017784-4r3fpmlb 57 2 summary summary NN cord-017784-4r3fpmlb 57 3 , , , cord-017784-4r3fpmlb 57 4 antibiotics antibiotic NNS cord-017784-4r3fpmlb 57 5 should should MD cord-017784-4r3fpmlb 57 6 be be VB cord-017784-4r3fpmlb 57 7 given give VBN cord-017784-4r3fpmlb 57 8 to to IN cord-017784-4r3fpmlb 57 9 patients patient NNS cord-017784-4r3fpmlb 57 10 with with IN cord-017784-4r3fpmlb 57 11 exacerbations exacerbation NNS cord-017784-4r3fpmlb 57 12 of of IN cord-017784-4r3fpmlb 57 13 COPD COPD NNP cord-017784-4r3fpmlb 57 14 who who WP cord-017784-4r3fpmlb 57 15 have have VBP cord-017784-4r3fpmlb 57 16 three three CD cord-017784-4r3fpmlb 57 17 cardinal cardinal JJ cord-017784-4r3fpmlb 57 18 symptoms symptom NNS cord-017784-4r3fpmlb 57 19 : : : cord-017784-4r3fpmlb 57 20 increase increase VB cord-017784-4r3fpmlb 57 21 in in IN cord-017784-4r3fpmlb 57 22 dyspnea dyspnea NN cord-017784-4r3fpmlb 57 23 , , , cord-017784-4r3fpmlb 57 24 sputum sputum NN cord-017784-4r3fpmlb 57 25 volume volume NN cord-017784-4r3fpmlb 57 26 , , , cord-017784-4r3fpmlb 57 27 and and CC cord-017784-4r3fpmlb 57 28 sputum sputum NN cord-017784-4r3fpmlb 57 29 purulence purulence NN cord-017784-4r3fpmlb 57 30 ; ; : cord-017784-4r3fpmlb 57 31 have have VB cord-017784-4r3fpmlb 57 32 two two CD cord-017784-4r3fpmlb 57 33 of of IN cord-017784-4r3fpmlb 57 34 the the DT cord-017784-4r3fpmlb 57 35 cardinal cardinal JJ cord-017784-4r3fpmlb 57 36 symptoms symptom NNS cord-017784-4r3fpmlb 57 37 if if IN cord-017784-4r3fpmlb 57 38 increased increase VBN cord-017784-4r3fpmlb 57 39 purulence purulence NN cord-017784-4r3fpmlb 57 40 of of IN cord-017784-4r3fpmlb 57 41 sputum sputum NN cord-017784-4r3fpmlb 57 42 is be VBZ cord-017784-4r3fpmlb 57 43 one one CD cord-017784-4r3fpmlb 57 44 of of IN cord-017784-4r3fpmlb 57 45 the the DT cord-017784-4r3fpmlb 57 46 two two CD cord-017784-4r3fpmlb 57 47 symptoms symptom NNS cord-017784-4r3fpmlb 57 48 ; ; : cord-017784-4r3fpmlb 57 49 or or CC cord-017784-4r3fpmlb 57 50 require require VB cord-017784-4r3fpmlb 57 51 mechanical mechanical JJ cord-017784-4r3fpmlb 57 52 ventilation ventilation NN cord-017784-4r3fpmlb 57 53 ( ( -LRB- cord-017784-4r3fpmlb 57 54 invasive invasive JJ cord-017784-4r3fpmlb 57 55 or or CC cord-017784-4r3fpmlb 57 56 non non JJ cord-017784-4r3fpmlb 57 57 - - JJ cord-017784-4r3fpmlb 57 58 invasive invasive JJ cord-017784-4r3fpmlb 57 59 ) ) -RRB- cord-017784-4r3fpmlb 57 60 [ [ -LRB- cord-017784-4r3fpmlb 57 61 10 10 CD cord-017784-4r3fpmlb 57 62 ] ] -RRB- cord-017784-4r3fpmlb 57 63 . . . cord-017784-4r3fpmlb 58 1 ( ( -LRB- cord-017784-4r3fpmlb 58 2 Table table NN cord-017784-4r3fpmlb 58 3 5 5 CD cord-017784-4r3fpmlb 58 4 . . . cord-017784-4r3fpmlb 58 5 _SP cord-017784-4r3fpmlb 59 1 After after IN cord-017784-4r3fpmlb 59 2 the the DT cord-017784-4r3fpmlb 59 3 decision decision NN cord-017784-4r3fpmlb 59 4 to to TO cord-017784-4r3fpmlb 59 5 initiate initiate VB cord-017784-4r3fpmlb 59 6 empirical empirical JJ cord-017784-4r3fpmlb 59 7 antibiotic antibiotic JJ cord-017784-4r3fpmlb 59 8 therapy therapy NN cord-017784-4r3fpmlb 59 9 , , , cord-017784-4r3fpmlb 59 10 the the DT cord-017784-4r3fpmlb 59 11 choice choice NN cord-017784-4r3fpmlb 59 12 of of IN cord-017784-4r3fpmlb 59 13 empirical empirical JJ cord-017784-4r3fpmlb 59 14 antibiotic antibiotic JJ cord-017784-4r3fpmlb 59 15 regimen regimen NN cord-017784-4r3fpmlb 59 16 most most RBS cord-017784-4r3fpmlb 59 17 appropriate appropriate JJ cord-017784-4r3fpmlb 59 18 for for IN cord-017784-4r3fpmlb 59 19 treating treat VBG cord-017784-4r3fpmlb 59 20 an an DT cord-017784-4r3fpmlb 59 21 episode episode NN cord-017784-4r3fpmlb 59 22 of of IN cord-017784-4r3fpmlb 59 23 AECOPD AECOPD NNP cord-017784-4r3fpmlb 59 24 should should MD cord-017784-4r3fpmlb 59 25 be be VB cord-017784-4r3fpmlb 59 26 based base VBN cord-017784-4r3fpmlb 59 27 on on IN cord-017784-4r3fpmlb 59 28 the the DT cord-017784-4r3fpmlb 59 29 following follow VBG cord-017784-4r3fpmlb 59 30 : : : cord-017784-4r3fpmlb 59 31 1 1 CD cord-017784-4r3fpmlb 59 32 . . . cord-017784-4r3fpmlb 60 1 The the DT cord-017784-4r3fpmlb 60 2 severity severity NN cord-017784-4r3fpmlb 60 3 of of IN cord-017784-4r3fpmlb 60 4 COPD COPD NNP cord-017784-4r3fpmlb 60 5 , , , cord-017784-4r3fpmlb 60 6 established establish VBN cord-017784-4r3fpmlb 60 7 by by IN cord-017784-4r3fpmlb 60 8 FEV1 FEV1 NNP cord-017784-4r3fpmlb 60 9 and and CC cord-017784-4r3fpmlb 60 10 the the DT cord-017784-4r3fpmlb 60 11 history history NN cord-017784-4r3fpmlb 60 12 of of IN cord-017784-4r3fpmlb 60 13 more more JJR cord-017784-4r3fpmlb 60 14 than than IN cord-017784-4r3fpmlb 60 15 three three CD cord-017784-4r3fpmlb 60 16 exacerbations exacerbation NNS cord-017784-4r3fpmlb 60 17 in in IN cord-017784-4r3fpmlb 60 18 the the DT cord-017784-4r3fpmlb 60 19 previous previous JJ cord-017784-4r3fpmlb 60 20 12 12 CD cord-017784-4r3fpmlb 60 21 months month NNS cord-017784-4r3fpmlb 60 22 . . . cord-017784-4r3fpmlb 61 1 2 2 LS cord-017784-4r3fpmlb 61 2 . . . cord-017784-4r3fpmlb 62 1 The the DT cord-017784-4r3fpmlb 62 2 patients patient NNS cord-017784-4r3fpmlb 62 3 age age NN cord-017784-4r3fpmlb 62 4 ( ( -LRB- cord-017784-4r3fpmlb 62 5 ≥ ≥ CD cord-017784-4r3fpmlb 62 6 or or CC cord-017784-4r3fpmlb 62 7 < < XX cord-017784-4r3fpmlb 62 8 65 65 CD cord-017784-4r3fpmlb 62 9 years year NNS cord-017784-4r3fpmlb 62 10 ) ) -RRB- cord-017784-4r3fpmlb 62 11 . . . cord-017784-4r3fpmlb 63 1 3 3 LS cord-017784-4r3fpmlb 63 2 . . . cord-017784-4r3fpmlb 64 1 Significant significant JJ cord-017784-4r3fpmlb 64 2 comorbidity comorbidity NN cord-017784-4r3fpmlb 64 3 ( ( -LRB- cord-017784-4r3fpmlb 64 4 diabetes diabetes NN cord-017784-4r3fpmlb 64 5 mellitus mellitus NN cord-017784-4r3fpmlb 64 6 , , , cord-017784-4r3fpmlb 64 7 liver liver NN cord-017784-4r3fpmlb 64 8 cirrhosis cirrhosis NN cord-017784-4r3fpmlb 64 9 , , , cord-017784-4r3fpmlb 64 10 chronic chronic JJ cord-017784-4r3fpmlb 64 11 renal renal JJ cord-017784-4r3fpmlb 64 12 failure failure NN cord-017784-4r3fpmlb 64 13 , , , cord-017784-4r3fpmlb 64 14 or or CC cord-017784-4r3fpmlb 64 15 heart heart NN cord-017784-4r3fpmlb 64 16 disease disease NN cord-017784-4r3fpmlb 64 17 ) ) -RRB- cord-017784-4r3fpmlb 64 18 . . . cord-017784-4r3fpmlb 65 1 4 4 LS cord-017784-4r3fpmlb 65 2 . . . cord-017784-4r3fpmlb 66 1 The the DT cord-017784-4r3fpmlb 66 2 risk risk NN cord-017784-4r3fpmlb 66 3 of of IN cord-017784-4r3fpmlb 66 4 infection infection NN cord-017784-4r3fpmlb 66 5 due due JJ cord-017784-4r3fpmlb 66 6 to to IN cord-017784-4r3fpmlb 66 7 P. P. NNP cord-017784-4r3fpmlb 66 8 aeruginosa aeruginosa NNP cord-017784-4r3fpmlb 66 9 , , , cord-017784-4r3fpmlb 66 10 which which WDT cord-017784-4r3fpmlb 66 11 must must MD cord-017784-4r3fpmlb 66 12 be be VB cord-017784-4r3fpmlb 66 13 considered consider VBN cord-017784-4r3fpmlb 66 14 in in IN cord-017784-4r3fpmlb 66 15 the the DT cord-017784-4r3fpmlb 66 16 presence presence NN cord-017784-4r3fpmlb 66 17 of of IN cord-017784-4r3fpmlb 66 18 two two CD cord-017784-4r3fpmlb 66 19 of of IN cord-017784-4r3fpmlb 66 20 the the DT cord-017784-4r3fpmlb 66 21 following follow VBG cord-017784-4r3fpmlb 66 22 risk risk NN cord-017784-4r3fpmlb 66 23 factors factor NNS cord-017784-4r3fpmlb 66 24 : : : cord-017784-4r3fpmlb 66 25 recent recent JJ cord-017784-4r3fpmlb 66 26 hospitalization hospitalization NN cord-017784-4r3fpmlb 66 27 , , , cord-017784-4r3fpmlb 66 28 frequent frequent JJ cord-017784-4r3fpmlb 66 29 ( ( -LRB- cord-017784-4r3fpmlb 66 30 > > NFP cord-017784-4r3fpmlb 66 31 4 4 CD cord-017784-4r3fpmlb 66 32 times time NNS cord-017784-4r3fpmlb 66 33 / / SYM cord-017784-4r3fpmlb 66 34 year year NN cord-017784-4r3fpmlb 66 35 ) ) -RRB- cord-017784-4r3fpmlb 66 36 or or CC cord-017784-4r3fpmlb 66 37 recent recent JJ cord-017784-4r3fpmlb 66 38 ( ( -LRB- cord-017784-4r3fpmlb 66 39 within within IN cord-017784-4r3fpmlb 66 40 the the DT cord-017784-4r3fpmlb 66 41 previous previous JJ cord-017784-4r3fpmlb 66 42 3 3 CD cord-017784-4r3fpmlb 66 43 months month NNS cord-017784-4r3fpmlb 66 44 ) ) -RRB- cord-017784-4r3fpmlb 66 45 administration administration NN cord-017784-4r3fpmlb 66 46 of of IN cord-017784-4r3fpmlb 66 47 antibiotics antibiotic NNS cord-017784-4r3fpmlb 66 48 , , , cord-017784-4r3fpmlb 66 49 severe severe JJ cord-017784-4r3fpmlb 66 50 disease disease NN cord-017784-4r3fpmlb 66 51 ( ( -LRB- cord-017784-4r3fpmlb 66 52 FEV1 FEV1 NNP cord-017784-4r3fpmlb 66 53 < < XX cord-017784-4r3fpmlb 66 54 30 30 CD cord-017784-4r3fpmlb 66 55 % % NN cord-017784-4r3fpmlb 66 56 ) ) -RRB- cord-017784-4r3fpmlb 66 57 , , , cord-017784-4r3fpmlb 66 58 or or CC cord-017784-4r3fpmlb 66 59 the the DT cord-017784-4r3fpmlb 66 60 use use NN cord-017784-4r3fpmlb 66 61 of of IN cord-017784-4r3fpmlb 66 62 oral oral JJ cord-017784-4r3fpmlb 66 63 corticosteroids corticosteroid NNS cord-017784-4r3fpmlb 66 64 ( ( -LRB- cord-017784-4r3fpmlb 66 65 > > NFP cord-017784-4r3fpmlb 66 66 10 10 CD cord-017784-4r3fpmlb 66 67 mg mg NN cord-017784-4r3fpmlb 66 68 of of IN cord-017784-4r3fpmlb 66 69 prednisone prednisone NNP cord-017784-4r3fpmlb 66 70 daily daily RB cord-017784-4r3fpmlb 66 71 in in IN cord-017784-4r3fpmlb 66 72 the the DT cord-017784-4r3fpmlb 66 73 previous previous JJ cord-017784-4r3fpmlb 66 74 2 2 CD cord-017784-4r3fpmlb 66 75 weeks week NNS cord-017784-4r3fpmlb 66 76 ) ) -RRB- cord-017784-4r3fpmlb 66 77 . . . cord-017784-4r3fpmlb 67 1 Between between IN cord-017784-4r3fpmlb 67 2 10 10 CD cord-017784-4r3fpmlb 67 3 % % NN cord-017784-4r3fpmlb 67 4 and and CC cord-017784-4r3fpmlb 67 5 20 20 CD cord-017784-4r3fpmlb 67 6 % % NN cord-017784-4r3fpmlb 67 7 of of IN cord-017784-4r3fpmlb 67 8 patients patient NNS cord-017784-4r3fpmlb 67 9 with with IN cord-017784-4r3fpmlb 67 10 moderate moderate JJ cord-017784-4r3fpmlb 67 11 to to IN cord-017784-4r3fpmlb 67 12 severe severe JJ cord-017784-4r3fpmlb 67 13 exacerbations exacerbation NNS cord-017784-4r3fpmlb 67 14 do do VBP cord-017784-4r3fpmlb 67 15 not not RB cord-017784-4r3fpmlb 67 16 respond respond VB cord-017784-4r3fpmlb 67 17 to to IN cord-017784-4r3fpmlb 67 18 initial initial JJ cord-017784-4r3fpmlb 67 19 empirical empirical JJ cord-017784-4r3fpmlb 67 20 therapy therapy NN cord-017784-4r3fpmlb 67 21 and and CC cord-017784-4r3fpmlb 67 22 require require VB cord-017784-4r3fpmlb 67 23 a a DT cord-017784-4r3fpmlb 67 24 change change NN cord-017784-4r3fpmlb 67 25 of of IN cord-017784-4r3fpmlb 67 26 antibiotic antibiotic NN cord-017784-4r3fpmlb 67 27 . . . cord-017784-4r3fpmlb 68 1 In in IN cord-017784-4r3fpmlb 68 2 these these DT cord-017784-4r3fpmlb 68 3 cases case NNS cord-017784-4r3fpmlb 68 4 , , , cord-017784-4r3fpmlb 68 5 the the DT cord-017784-4r3fpmlb 68 6 infection infection NN cord-017784-4r3fpmlb 68 7 can can MD cord-017784-4r3fpmlb 68 8 be be VB cord-017784-4r3fpmlb 68 9 caused cause VBN cord-017784-4r3fpmlb 68 10 by by IN cord-017784-4r3fpmlb 68 11 Staphylococcus Staphylococcus NNP cord-017784-4r3fpmlb 68 12 aureus aureus NN cord-017784-4r3fpmlb 68 13 , , , cord-017784-4r3fpmlb 68 14 P. P. NNP cord-017784-4r3fpmlb 68 15 aeruginosa aeruginosa NN cord-017784-4r3fpmlb 68 16 , , , cord-017784-4r3fpmlb 68 17 or or CC cord-017784-4r3fpmlb 68 18 some some DT cord-017784-4r3fpmlb 68 19 atypical atypical JJ cord-017784-4r3fpmlb 68 20 microorganism microorganism NN cord-017784-4r3fpmlb 68 21 not not RB cord-017784-4r3fpmlb 68 22 covered cover VBN cord-017784-4r3fpmlb 68 23 by by IN cord-017784-4r3fpmlb 68 24 the the DT cord-017784-4r3fpmlb 68 25 initial initial JJ cord-017784-4r3fpmlb 68 26 regimen regimen NN cord-017784-4r3fpmlb 68 27 or or CC cord-017784-4r3fpmlb 68 28 because because IN cord-017784-4r3fpmlb 68 29 of of IN cord-017784-4r3fpmlb 68 30 resistant resistant JJ cord-017784-4r3fpmlb 68 31 organisms organism NNS cord-017784-4r3fpmlb 68 32 ( ( -LRB- cord-017784-4r3fpmlb 68 33 such such JJ cord-017784-4r3fpmlb 68 34 as as IN cord-017784-4r3fpmlb 68 35 S. S. NNP cord-017784-4r3fpmlb 68 36 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 68 37 ) ) -RRB- cord-017784-4r3fpmlb 68 38 ; ; : cord-017784-4r3fpmlb 68 39 hence hence RB cord-017784-4r3fpmlb 68 40 , , , cord-017784-4r3fpmlb 68 41 a a DT cord-017784-4r3fpmlb 68 42 microbiological microbiological JJ cord-017784-4r3fpmlb 68 43 assessment assessment NN cord-017784-4r3fpmlb 68 44 would would MD cord-017784-4r3fpmlb 68 45 help help VB cord-017784-4r3fpmlb 68 46 to to TO cord-017784-4r3fpmlb 68 47 adjust adjust VB cord-017784-4r3fpmlb 68 48 the the DT cord-017784-4r3fpmlb 68 49 antibiotic antibiotic JJ cord-017784-4r3fpmlb 68 50 treatment treatment NN cord-017784-4r3fpmlb 68 51 of of IN cord-017784-4r3fpmlb 68 52 second second JJ cord-017784-4r3fpmlb 68 53 choice choice NN cord-017784-4r3fpmlb 68 54 [ [ -LRB- cord-017784-4r3fpmlb 68 55 17 17 CD cord-017784-4r3fpmlb 68 56 ] ] -RRB- cord-017784-4r3fpmlb 68 57 . . . cord-017784-4r3fpmlb 69 1 There there EX cord-017784-4r3fpmlb 69 2 are be VBP cord-017784-4r3fpmlb 69 3 not not RB cord-017784-4r3fpmlb 69 4 enough enough JJ cord-017784-4r3fpmlb 69 5 data datum NNS cord-017784-4r3fpmlb 69 6 concerning concern VBG cord-017784-4r3fpmlb 69 7 the the DT cord-017784-4r3fpmlb 69 8 role role NN cord-017784-4r3fpmlb 69 9 of of IN cord-017784-4r3fpmlb 69 10 antiviral antiviral JJ cord-017784-4r3fpmlb 69 11 therapy therapy NN cord-017784-4r3fpmlb 69 12 in in IN cord-017784-4r3fpmlb 69 13 respiratory respiratory JJ cord-017784-4r3fpmlb 69 14 failure failure NN cord-017784-4r3fpmlb 69 15 due due IN cord-017784-4r3fpmlb 69 16 to to IN cord-017784-4r3fpmlb 69 17 COPD COPD NNP cord-017784-4r3fpmlb 69 18 . . . cord-017784-4r3fpmlb 70 1 There there EX cord-017784-4r3fpmlb 70 2 are be VBP cord-017784-4r3fpmlb 70 3 no no DT cord-017784-4r3fpmlb 70 4 standard standard JJ cord-017784-4r3fpmlb 70 5 procedures procedure NNS cord-017784-4r3fpmlb 70 6 that that WDT cord-017784-4r3fpmlb 70 7 determine determine VBP cord-017784-4r3fpmlb 70 8 the the DT cord-017784-4r3fpmlb 70 9 dose dose NN cord-017784-4r3fpmlb 70 10 and and CC cord-017784-4r3fpmlb 70 11 duration duration NN cord-017784-4r3fpmlb 70 12 of of IN cord-017784-4r3fpmlb 70 13 antibiotic antibiotic JJ cord-017784-4r3fpmlb 70 14 treatment treatment NN cord-017784-4r3fpmlb 70 15 in in IN cord-017784-4r3fpmlb 70 16 patients patient NNS cord-017784-4r3fpmlb 70 17 with with IN cord-017784-4r3fpmlb 70 18 AECOPD AECOPD NNP cord-017784-4r3fpmlb 70 19 . . . cord-017784-4r3fpmlb 71 1 Therefore therefore RB cord-017784-4r3fpmlb 71 2 , , , cord-017784-4r3fpmlb 71 3 several several JJ cord-017784-4r3fpmlb 71 4 studies study NNS cord-017784-4r3fpmlb 71 5 demonstrate demonstrate VBP cord-017784-4r3fpmlb 71 6 that that IN cord-017784-4r3fpmlb 71 7 short short JJ cord-017784-4r3fpmlb 71 8 - - HYPH cord-017784-4r3fpmlb 71 9 term term NN cord-017784-4r3fpmlb 71 10 antibiotic antibiotic JJ cord-017784-4r3fpmlb 71 11 use use NN cord-017784-4r3fpmlb 71 12 is be VBZ cord-017784-4r3fpmlb 71 13 associated associate VBN cord-017784-4r3fpmlb 71 14 with with IN cord-017784-4r3fpmlb 71 15 very very RB cord-017784-4r3fpmlb 71 16 important important JJ cord-017784-4r3fpmlb 71 17 advantages advantage NNS cord-017784-4r3fpmlb 71 18 such such JJ cord-017784-4r3fpmlb 71 19 as as IN cord-017784-4r3fpmlb 71 20 reduction reduction NN cord-017784-4r3fpmlb 71 21 of of IN cord-017784-4r3fpmlb 71 22 exposure exposure NN cord-017784-4r3fpmlb 71 23 that that WDT cord-017784-4r3fpmlb 71 24 will will MD cord-017784-4r3fpmlb 71 25 result result VB cord-017784-4r3fpmlb 71 26 in in IN cord-017784-4r3fpmlb 71 27 decreased decrease VBN cord-017784-4r3fpmlb 71 28 bacterial bacterial JJ cord-017784-4r3fpmlb 71 29 resistance resistance NN cord-017784-4r3fpmlb 71 30 , , , cord-017784-4r3fpmlb 71 31 enhanced enhanced JJ cord-017784-4r3fpmlb 71 32 compliance compliance NN cord-017784-4r3fpmlb 71 33 , , , cord-017784-4r3fpmlb 71 34 and and CC cord-017784-4r3fpmlb 71 35 decreased decrease VBD cord-017784-4r3fpmlb 71 36 side side JJ cord-017784-4r3fpmlb 71 37 effects effect NNS cord-017784-4r3fpmlb 71 38 . . . cord-017784-4r3fpmlb 72 1 The the DT cord-017784-4r3fpmlb 72 2 recommended recommend VBN cord-017784-4r3fpmlb 72 3 length length NN cord-017784-4r3fpmlb 72 4 of of IN cord-017784-4r3fpmlb 72 5 antibiotics antibiotic NNS cord-017784-4r3fpmlb 72 6 therapy therapy NN cord-017784-4r3fpmlb 72 7 is be VBZ cord-017784-4r3fpmlb 72 8 5 5 CD cord-017784-4r3fpmlb 72 9 - - SYM cord-017784-4r3fpmlb 72 10 7 7 CD cord-017784-4r3fpmlb 72 11 days day NNS cord-017784-4r3fpmlb 72 12 [ [ -LRB- cord-017784-4r3fpmlb 72 13 10 10 CD cord-017784-4r3fpmlb 72 14 ] ] -RRB- cord-017784-4r3fpmlb 72 15 . . . cord-017784-4r3fpmlb 73 1 The the DT cord-017784-4r3fpmlb 73 2 incidence incidence NN cord-017784-4r3fpmlb 73 3 of of IN cord-017784-4r3fpmlb 73 4 community community NN cord-017784-4r3fpmlb 73 5 - - HYPH cord-017784-4r3fpmlb 73 6 acquired acquire VBN cord-017784-4r3fpmlb 73 7 pneumonia pneumonia NN cord-017784-4r3fpmlb 73 8 increases increase VBZ cord-017784-4r3fpmlb 73 9 with with IN cord-017784-4r3fpmlb 73 10 age age NN cord-017784-4r3fpmlb 73 11 , , , cord-017784-4r3fpmlb 73 12 reaching reach VBG cord-017784-4r3fpmlb 73 13 25 25 CD cord-017784-4r3fpmlb 73 14 - - SYM cord-017784-4r3fpmlb 73 15 44 44 CD cord-017784-4r3fpmlb 73 16 cases case NNS cord-017784-4r3fpmlb 73 17 per per IN cord-017784-4r3fpmlb 73 18 1000 1000 CD cord-017784-4r3fpmlb 73 19 inhabitants inhabitant NNS cord-017784-4r3fpmlb 73 20 / / SYM cord-017784-4r3fpmlb 73 21 year year NN cord-017784-4r3fpmlb 73 22 in in IN cord-017784-4r3fpmlb 73 23 the the DT cord-017784-4r3fpmlb 73 24 population population NN cord-017784-4r3fpmlb 73 25 over over IN cord-017784-4r3fpmlb 73 26 the the DT cord-017784-4r3fpmlb 73 27 age age NN cord-017784-4r3fpmlb 73 28 of of IN cord-017784-4r3fpmlb 73 29 65 65 CD cord-017784-4r3fpmlb 73 30 years year NNS cord-017784-4r3fpmlb 73 31 , , , cord-017784-4r3fpmlb 73 32 up up IN cord-017784-4r3fpmlb 73 33 to to TO cord-017784-4r3fpmlb 73 34 four four CD cord-017784-4r3fpmlb 73 35 times time NNS cord-017784-4r3fpmlb 73 36 that that DT cord-017784-4r3fpmlb 73 37 of of IN cord-017784-4r3fpmlb 73 38 younger young JJR cord-017784-4r3fpmlb 73 39 patients patient NNS cord-017784-4r3fpmlb 73 40 [ [ -LRB- cord-017784-4r3fpmlb 73 41 18 18 CD cord-017784-4r3fpmlb 73 42 ] ] -RRB- cord-017784-4r3fpmlb 73 43 . . . cord-017784-4r3fpmlb 74 1 Elderly elderly JJ cord-017784-4r3fpmlb 74 2 patients patient NNS cord-017784-4r3fpmlb 74 3 are be VBP cord-017784-4r3fpmlb 74 4 more more RBR cord-017784-4r3fpmlb 74 5 predisposed predisposed JJ cord-017784-4r3fpmlb 74 6 to to IN cord-017784-4r3fpmlb 74 7 pneumonia pneumonia NN cord-017784-4r3fpmlb 74 8 because because IN cord-017784-4r3fpmlb 74 9 of of IN cord-017784-4r3fpmlb 74 10 their -PRON- PRP$ cord-017784-4r3fpmlb 74 11 impaired impair VBN cord-017784-4r3fpmlb 74 12 gag gag NN cord-017784-4r3fpmlb 74 13 reflex reflex NN cord-017784-4r3fpmlb 74 14 , , , cord-017784-4r3fpmlb 74 15 decreased decrease VBD cord-017784-4r3fpmlb 74 16 mucociliary mucociliary JJ cord-017784-4r3fpmlb 74 17 function function NN cord-017784-4r3fpmlb 74 18 , , , cord-017784-4r3fpmlb 74 19 waning wane VBG cord-017784-4r3fpmlb 74 20 immunity immunity NN cord-017784-4r3fpmlb 74 21 , , , cord-017784-4r3fpmlb 74 22 impaired impair VBN cord-017784-4r3fpmlb 74 23 febrile febrile JJ cord-017784-4r3fpmlb 74 24 response response NN cord-017784-4r3fpmlb 74 25 , , , cord-017784-4r3fpmlb 74 26 and and CC cord-017784-4r3fpmlb 74 27 chronic chronic JJ cord-017784-4r3fpmlb 74 28 disease disease NN cord-017784-4r3fpmlb 74 29 ( ( -LRB- cord-017784-4r3fpmlb 74 30 diabetes diabetes NN cord-017784-4r3fpmlb 74 31 mellitus mellitus NN cord-017784-4r3fpmlb 74 32 , , , cord-017784-4r3fpmlb 74 33 chronic chronic JJ cord-017784-4r3fpmlb 74 34 obstructive obstructive JJ cord-017784-4r3fpmlb 74 35 pulmonary pulmonary JJ cord-017784-4r3fpmlb 74 36 disease disease NN cord-017784-4r3fpmlb 74 37 , , , cord-017784-4r3fpmlb 74 38 chronic chronic JJ cord-017784-4r3fpmlb 74 39 heart heart NN cord-017784-4r3fpmlb 74 40 failure failure NN cord-017784-4r3fpmlb 74 41 , , , cord-017784-4r3fpmlb 74 42 cancer cancer NN cord-017784-4r3fpmlb 74 43 and and CC cord-017784-4r3fpmlb 74 44 chronic chronic JJ cord-017784-4r3fpmlb 74 45 renal renal JJ cord-017784-4r3fpmlb 74 46 insufficiency insufficiency NN cord-017784-4r3fpmlb 74 47 ) ) -RRB- cord-017784-4r3fpmlb 74 48 . . . cord-017784-4r3fpmlb 75 1 Furthermore furthermore RB cord-017784-4r3fpmlb 75 2 , , , cord-017784-4r3fpmlb 75 3 central central JJ cord-017784-4r3fpmlb 75 4 nervous nervous JJ cord-017784-4r3fpmlb 75 5 system system NN cord-017784-4r3fpmlb 75 6 disorders disorder NNS cord-017784-4r3fpmlb 75 7 and/or and/or CC cord-017784-4r3fpmlb 75 8 an an DT cord-017784-4r3fpmlb 75 9 impaired impaired JJ cord-017784-4r3fpmlb 75 10 gag gag NN cord-017784-4r3fpmlb 75 11 reflex reflex NN cord-017784-4r3fpmlb 75 12 predispose predispose VB cord-017784-4r3fpmlb 75 13 elderly elderly JJ cord-017784-4r3fpmlb 75 14 patients patient NNS cord-017784-4r3fpmlb 75 15 to to IN cord-017784-4r3fpmlb 75 16 aspiration aspiration NN cord-017784-4r3fpmlb 75 17 pneumonia pneumonia NN cord-017784-4r3fpmlb 75 18 . . . cord-017784-4r3fpmlb 76 1 With with IN cord-017784-4r3fpmlb 76 2 respect respect NN cord-017784-4r3fpmlb 76 3 to to IN cord-017784-4r3fpmlb 76 4 the the DT cord-017784-4r3fpmlb 76 5 youngest young JJS cord-017784-4r3fpmlb 76 6 population population NN cord-017784-4r3fpmlb 76 7 , , , cord-017784-4r3fpmlb 76 8 pneumonia pneumonia NN cord-017784-4r3fpmlb 76 9 in in IN cord-017784-4r3fpmlb 76 10 the the DT cord-017784-4r3fpmlb 76 11 elderly elderly JJ cord-017784-4r3fpmlb 76 12 subjects subject NNS cord-017784-4r3fpmlb 76 13 is be VBZ cord-017784-4r3fpmlb 76 14 more more RBR cord-017784-4r3fpmlb 76 15 severe severe JJ cord-017784-4r3fpmlb 76 16 , , , cord-017784-4r3fpmlb 76 17 requires require VBZ cord-017784-4r3fpmlb 76 18 often often RB cord-017784-4r3fpmlb 76 19 hospitalization hospitalization NN cord-017784-4r3fpmlb 76 20 , , , cord-017784-4r3fpmlb 76 21 and and CC cord-017784-4r3fpmlb 76 22 is be VBZ cord-017784-4r3fpmlb 76 23 characterized characterize VBN cord-017784-4r3fpmlb 76 24 by by IN cord-017784-4r3fpmlb 76 25 a a DT cord-017784-4r3fpmlb 76 26 longer long JJR cord-017784-4r3fpmlb 76 27 length length NN cord-017784-4r3fpmlb 76 28 of of IN cord-017784-4r3fpmlb 76 29 stay stay NN cord-017784-4r3fpmlb 76 30 and and CC cord-017784-4r3fpmlb 76 31 by by IN cord-017784-4r3fpmlb 76 32 greater great JJR cord-017784-4r3fpmlb 76 33 mortality mortality NN cord-017784-4r3fpmlb 76 34 , , , cord-017784-4r3fpmlb 76 35 particularly particularly RB cord-017784-4r3fpmlb 76 36 in in IN cord-017784-4r3fpmlb 76 37 patients patient NNS cord-017784-4r3fpmlb 76 38 with with IN cord-017784-4r3fpmlb 76 39 comorbidities comorbiditie NNS cord-017784-4r3fpmlb 76 40 [ [ -LRB- cord-017784-4r3fpmlb 76 41 19 19 CD cord-017784-4r3fpmlb 76 42 ] ] -RRB- cord-017784-4r3fpmlb 76 43 . . . cord-017784-4r3fpmlb 77 1 It -PRON- PRP cord-017784-4r3fpmlb 77 2 is be VBZ cord-017784-4r3fpmlb 77 3 important important JJ cord-017784-4r3fpmlb 77 4 to to TO cord-017784-4r3fpmlb 77 5 remember remember VB cord-017784-4r3fpmlb 77 6 that that IN cord-017784-4r3fpmlb 77 7 clinical clinical JJ cord-017784-4r3fpmlb 77 8 presentation presentation NN cord-017784-4r3fpmlb 77 9 of of IN cord-017784-4r3fpmlb 77 10 pneumonia pneumonia NN cord-017784-4r3fpmlb 77 11 in in IN cord-017784-4r3fpmlb 77 12 the the DT cord-017784-4r3fpmlb 77 13 elderly elderly JJ cord-017784-4r3fpmlb 77 14 may may MD cord-017784-4r3fpmlb 77 15 be be VB cord-017784-4r3fpmlb 77 16 subtle subtle JJ cord-017784-4r3fpmlb 77 17 and and CC cord-017784-4r3fpmlb 77 18 may may MD cord-017784-4r3fpmlb 77 19 be be VB cord-017784-4r3fpmlb 77 20 afebrile afebrile JJ cord-017784-4r3fpmlb 77 21 . . . cord-017784-4r3fpmlb 78 1 Altered alter VBN cord-017784-4r3fpmlb 78 2 mental mental JJ cord-017784-4r3fpmlb 78 3 status status NN cord-017784-4r3fpmlb 78 4 , , , cord-017784-4r3fpmlb 78 5 a a DT cord-017784-4r3fpmlb 78 6 sudden sudden JJ cord-017784-4r3fpmlb 78 7 decline decline NN cord-017784-4r3fpmlb 78 8 in in IN cord-017784-4r3fpmlb 78 9 functional functional JJ cord-017784-4r3fpmlb 78 10 capacity capacity NN cord-017784-4r3fpmlb 78 11 , , , cord-017784-4r3fpmlb 78 12 worsening worsen VBG cord-017784-4r3fpmlb 78 13 of of IN cord-017784-4r3fpmlb 78 14 underlying underlie VBG cord-017784-4r3fpmlb 78 15 diseases disease NNS cord-017784-4r3fpmlb 78 16 , , , cord-017784-4r3fpmlb 78 17 and and CC cord-017784-4r3fpmlb 78 18 falls fall VBZ cord-017784-4r3fpmlb 78 19 may may MD cord-017784-4r3fpmlb 78 20 be be VB cord-017784-4r3fpmlb 78 21 the the DT cord-017784-4r3fpmlb 78 22 only only JJ cord-017784-4r3fpmlb 78 23 findings finding NNS cord-017784-4r3fpmlb 78 24 . . . cord-017784-4r3fpmlb 79 1 As as IN cord-017784-4r3fpmlb 79 2 stated state VBN cord-017784-4r3fpmlb 79 3 by by IN cord-017784-4r3fpmlb 79 4 Sir Sir NNP cord-017784-4r3fpmlb 79 5 William William NNP cord-017784-4r3fpmlb 79 6 Osler Osler NNP cord-017784-4r3fpmlb 79 7 [ [ -LRB- cord-017784-4r3fpmlb 79 8 20 20 CD cord-017784-4r3fpmlb 79 9 ] ] -RRB- cord-017784-4r3fpmlb 79 10 " " `` cord-017784-4r3fpmlb 79 11 in in IN cord-017784-4r3fpmlb 79 12 old old JJ cord-017784-4r3fpmlb 79 13 age age NN cord-017784-4r3fpmlb 79 14 , , , cord-017784-4r3fpmlb 79 15 pneumonia pneumonia NN cord-017784-4r3fpmlb 79 16 may may MD cord-017784-4r3fpmlb 79 17 be be VB cord-017784-4r3fpmlb 79 18 latent latent JJ cord-017784-4r3fpmlb 79 19 , , , cord-017784-4r3fpmlb 79 20 coming come VBG cord-017784-4r3fpmlb 79 21 on on RP cord-017784-4r3fpmlb 79 22 without without IN cord-017784-4r3fpmlb 79 23 chill chill NN cord-017784-4r3fpmlb 79 24 , , , cord-017784-4r3fpmlb 79 25 the the DT cord-017784-4r3fpmlb 79 26 cough cough NN cord-017784-4r3fpmlb 79 27 and and CC cord-017784-4r3fpmlb 79 28 expectoration expectoration NN cord-017784-4r3fpmlb 79 29 are be VBP cord-017784-4r3fpmlb 79 30 slight slight JJ cord-017784-4r3fpmlb 79 31 , , , cord-017784-4r3fpmlb 79 32 the the DT cord-017784-4r3fpmlb 79 33 physical physical JJ cord-017784-4r3fpmlb 79 34 signs sign NNS cord-017784-4r3fpmlb 79 35 ill ill RB cord-017784-4r3fpmlb 79 36 defined defined JJ cord-017784-4r3fpmlb 79 37 and and CC cord-017784-4r3fpmlb 79 38 changeable changeable JJ cord-017784-4r3fpmlb 79 39 , , , cord-017784-4r3fpmlb 79 40 and and CC cord-017784-4r3fpmlb 79 41 the the DT cord-017784-4r3fpmlb 79 42 constitutional constitutional JJ cord-017784-4r3fpmlb 79 43 symptoms symptom NNS cord-017784-4r3fpmlb 79 44 out out IN cord-017784-4r3fpmlb 79 45 of of IN cord-017784-4r3fpmlb 79 46 all all DT cord-017784-4r3fpmlb 79 47 proportion proportion NN cord-017784-4r3fpmlb 79 48 . . . cord-017784-4r3fpmlb 80 1 " " '' cord-017784-4r3fpmlb 81 1 As as IN cord-017784-4r3fpmlb 81 2 with with IN cord-017784-4r3fpmlb 81 3 any any DT cord-017784-4r3fpmlb 81 4 infectious infectious JJ cord-017784-4r3fpmlb 81 5 disease disease NN cord-017784-4r3fpmlb 81 6 , , , cord-017784-4r3fpmlb 81 7 identifying identify VBG cord-017784-4r3fpmlb 81 8 the the DT cord-017784-4r3fpmlb 81 9 causative causative JJ cord-017784-4r3fpmlb 81 10 agent agent NN cord-017784-4r3fpmlb 81 11 in in IN cord-017784-4r3fpmlb 81 12 CAP CAP NNP cord-017784-4r3fpmlb 81 13 can can MD cord-017784-4r3fpmlb 81 14 be be VB cord-017784-4r3fpmlb 81 15 extremely extremely RB cord-017784-4r3fpmlb 81 16 useful useful JJ cord-017784-4r3fpmlb 81 17 in in IN cord-017784-4r3fpmlb 81 18 guiding guide VBG cord-017784-4r3fpmlb 81 19 antimicrobial antimicrobial JJ cord-017784-4r3fpmlb 81 20 therapy therapy NN cord-017784-4r3fpmlb 81 21 . . . cord-017784-4r3fpmlb 82 1 Unfortunately unfortunately RB cord-017784-4r3fpmlb 82 2 , , , cord-017784-4r3fpmlb 82 3 despite despite IN cord-017784-4r3fpmlb 82 4 the the DT cord-017784-4r3fpmlb 82 5 use use NN cord-017784-4r3fpmlb 82 6 of of IN cord-017784-4r3fpmlb 82 7 more more RBR cord-017784-4r3fpmlb 82 8 sensitive sensitive JJ cord-017784-4r3fpmlb 82 9 and and CC cord-017784-4r3fpmlb 82 10 specific specific JJ cord-017784-4r3fpmlb 82 11 diagnostic diagnostic JJ cord-017784-4r3fpmlb 82 12 methods method NNS cord-017784-4r3fpmlb 82 13 to to TO cord-017784-4r3fpmlb 82 14 define define VB cord-017784-4r3fpmlb 82 15 an an DT cord-017784-4r3fpmlb 82 16 etiologic etiologic JJ cord-017784-4r3fpmlb 82 17 pathogen pathogen NN cord-017784-4r3fpmlb 82 18 in in IN cord-017784-4r3fpmlb 82 19 community community NN cord-017784-4r3fpmlb 82 20 - - HYPH cord-017784-4r3fpmlb 82 21 acquired acquire VBN cord-017784-4r3fpmlb 82 22 pneumonia pneumonia NN cord-017784-4r3fpmlb 82 23 requiring require VBG cord-017784-4r3fpmlb 82 24 hospitalization hospitalization NN cord-017784-4r3fpmlb 82 25 , , , cord-017784-4r3fpmlb 82 26 in in IN cord-017784-4r3fpmlb 82 27 the the DT cord-017784-4r3fpmlb 82 28 majority majority NN cord-017784-4r3fpmlb 82 29 of of IN cord-017784-4r3fpmlb 82 30 patients patient NNS cord-017784-4r3fpmlb 82 31 , , , cord-017784-4r3fpmlb 82 32 a a DT cord-017784-4r3fpmlb 82 33 microbiologic microbiologic JJ cord-017784-4r3fpmlb 82 34 diagnosis diagnosis NN cord-017784-4r3fpmlb 82 35 can can MD cord-017784-4r3fpmlb 82 36 not not RB cord-017784-4r3fpmlb 82 37 be be VB cord-017784-4r3fpmlb 82 38 made make VBN cord-017784-4r3fpmlb 82 39 [ [ -LRB- cord-017784-4r3fpmlb 82 40 21 21 CD cord-017784-4r3fpmlb 82 41 ] ] -RRB- cord-017784-4r3fpmlb 82 42 . . . cord-017784-4r3fpmlb 83 1 In in IN cord-017784-4r3fpmlb 83 2 most most JJS cord-017784-4r3fpmlb 83 3 cases case NNS cord-017784-4r3fpmlb 83 4 , , , cord-017784-4r3fpmlb 83 5 the the DT cord-017784-4r3fpmlb 83 6 microbiologic microbiologic JJ cord-017784-4r3fpmlb 83 7 patterns pattern NNS cord-017784-4r3fpmlb 83 8 observed observe VBN cord-017784-4r3fpmlb 83 9 in in IN cord-017784-4r3fpmlb 83 10 the the DT cord-017784-4r3fpmlb 83 11 elderly elderly JJ cord-017784-4r3fpmlb 83 12 do do VBP cord-017784-4r3fpmlb 83 13 not not RB cord-017784-4r3fpmlb 83 14 differ differ VB cord-017784-4r3fpmlb 83 15 significantly significantly RB cord-017784-4r3fpmlb 83 16 from from IN cord-017784-4r3fpmlb 83 17 those those DT cord-017784-4r3fpmlb 83 18 observed observe VBN cord-017784-4r3fpmlb 83 19 in in IN cord-017784-4r3fpmlb 83 20 younger young JJR cord-017784-4r3fpmlb 83 21 populations population NNS cord-017784-4r3fpmlb 83 22 although although IN cord-017784-4r3fpmlb 83 23 with with IN cord-017784-4r3fpmlb 83 24 a a DT cord-017784-4r3fpmlb 83 25 different different JJ cord-017784-4r3fpmlb 83 26 age age NN cord-017784-4r3fpmlb 83 27 - - HYPH cord-017784-4r3fpmlb 83 28 related relate VBN cord-017784-4r3fpmlb 83 29 distribution distribution NN cord-017784-4r3fpmlb 83 30 . . . cord-017784-4r3fpmlb 84 1 Streptococcus streptococcus NN cord-017784-4r3fpmlb 84 2 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 84 3 is be VBZ cord-017784-4r3fpmlb 84 4 still still RB cord-017784-4r3fpmlb 84 5 the the DT cord-017784-4r3fpmlb 84 6 most most RBS cord-017784-4r3fpmlb 84 7 important important JJ cord-017784-4r3fpmlb 84 8 pathogen pathogen NN cord-017784-4r3fpmlb 84 9 in in IN cord-017784-4r3fpmlb 84 10 younger young JJR cord-017784-4r3fpmlb 84 11 as as RB cord-017784-4r3fpmlb 84 12 well well RB cord-017784-4r3fpmlb 84 13 as as IN cord-017784-4r3fpmlb 84 14 older old JJR cord-017784-4r3fpmlb 84 15 adults adult NNS cord-017784-4r3fpmlb 84 16 and and CC cord-017784-4r3fpmlb 84 17 the the DT cord-017784-4r3fpmlb 84 18 incidence incidence NN cord-017784-4r3fpmlb 84 19 of of IN cord-017784-4r3fpmlb 84 20 pneumococcal pneumococcal JJ cord-017784-4r3fpmlb 84 21 pneumonia pneumonia NN cord-017784-4r3fpmlb 84 22 generally generally RB cord-017784-4r3fpmlb 84 23 increases increase VBZ cord-017784-4r3fpmlb 84 24 with with IN cord-017784-4r3fpmlb 84 25 age age NN cord-017784-4r3fpmlb 84 26 . . . cord-017784-4r3fpmlb 85 1 Haemophilus haemophilus JJ cord-017784-4r3fpmlb 85 2 influenzae influenzae NN cord-017784-4r3fpmlb 85 3 is be VBZ cord-017784-4r3fpmlb 85 4 relatively relatively RB cord-017784-4r3fpmlb 85 5 more more RBR cord-017784-4r3fpmlb 85 6 common common JJ cord-017784-4r3fpmlb 85 7 in in IN cord-017784-4r3fpmlb 85 8 elderly elderly JJ cord-017784-4r3fpmlb 85 9 patients patient NNS cord-017784-4r3fpmlb 85 10 than than IN cord-017784-4r3fpmlb 85 11 in in IN cord-017784-4r3fpmlb 85 12 non non JJ cord-017784-4r3fpmlb 85 13 - - JJ cord-017784-4r3fpmlb 85 14 elderly elderly JJ cord-017784-4r3fpmlb 85 15 adults adult NNS cord-017784-4r3fpmlb 85 16 and and CC cord-017784-4r3fpmlb 85 17 are be VBP cord-017784-4r3fpmlb 85 18 the the DT cord-017784-4r3fpmlb 85 19 second second JJ cord-017784-4r3fpmlb 85 20 most most RBS cord-017784-4r3fpmlb 85 21 frequently frequently RB cord-017784-4r3fpmlb 85 22 identified identify VBN cord-017784-4r3fpmlb 85 23 microorganisms microorganism NNS cord-017784-4r3fpmlb 85 24 , , , cord-017784-4r3fpmlb 85 25 while while IN cord-017784-4r3fpmlb 85 26 Moraxella Moraxella NNP cord-017784-4r3fpmlb 85 27 catarrhalis catarrhalis NNP cord-017784-4r3fpmlb 85 28 is be VBZ cord-017784-4r3fpmlb 85 29 of of IN cord-017784-4r3fpmlb 85 30 particular particular JJ cord-017784-4r3fpmlb 85 31 importance importance NN cord-017784-4r3fpmlb 85 32 as as IN cord-017784-4r3fpmlb 85 33 a a DT cord-017784-4r3fpmlb 85 34 cause cause NN cord-017784-4r3fpmlb 85 35 of of IN cord-017784-4r3fpmlb 85 36 community community NN cord-017784-4r3fpmlb 85 37 - - HYPH cord-017784-4r3fpmlb 85 38 acquired acquire VBN cord-017784-4r3fpmlb 85 39 pneumonia pneumonia NN cord-017784-4r3fpmlb 85 40 in in IN cord-017784-4r3fpmlb 85 41 patients patient NNS cord-017784-4r3fpmlb 85 42 with with IN cord-017784-4r3fpmlb 85 43 chronic chronic JJ cord-017784-4r3fpmlb 85 44 bronchitis bronchitis NN cord-017784-4r3fpmlb 85 45 . . . cord-017784-4r3fpmlb 86 1 The the DT cord-017784-4r3fpmlb 86 2 most most RBS cord-017784-4r3fpmlb 86 3 discernible discernible JJ cord-017784-4r3fpmlb 86 4 differences difference NNS cord-017784-4r3fpmlb 86 5 between between IN cord-017784-4r3fpmlb 86 6 the the DT cord-017784-4r3fpmlb 86 7 two two CD cord-017784-4r3fpmlb 86 8 groups group NNS cord-017784-4r3fpmlb 86 9 were be VBD cord-017784-4r3fpmlb 86 10 Gram gram NN cord-017784-4r3fpmlb 86 11 - - HYPH cord-017784-4r3fpmlb 86 12 negatives negative NNS cord-017784-4r3fpmlb 86 13 , , , cord-017784-4r3fpmlb 86 14 especially especially RB cord-017784-4r3fpmlb 86 15 Enterobacteriaceae Enterobacteriaceae NNP cord-017784-4r3fpmlb 86 16 were be VBD cord-017784-4r3fpmlb 86 17 found find VBN cord-017784-4r3fpmlb 86 18 more more RBR cord-017784-4r3fpmlb 86 19 frequently frequently RB cord-017784-4r3fpmlb 86 20 in in IN cord-017784-4r3fpmlb 86 21 the the DT cord-017784-4r3fpmlb 86 22 elderly elderly JJ cord-017784-4r3fpmlb 86 23 , , , cord-017784-4r3fpmlb 86 24 whereas whereas IN cord-017784-4r3fpmlb 86 25 certain certain JJ cord-017784-4r3fpmlb 86 26 atypical atypical JJ cord-017784-4r3fpmlb 86 27 pathogens pathogen NNS cord-017784-4r3fpmlb 86 28 ( ( -LRB- cord-017784-4r3fpmlb 86 29 Legionella Legionella NNP cord-017784-4r3fpmlb 86 30 pneumophila pneumophila NN cord-017784-4r3fpmlb 86 31 , , , cord-017784-4r3fpmlb 86 32 Mycoplasma mycoplasma NN cord-017784-4r3fpmlb 86 33 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 86 34 , , , cord-017784-4r3fpmlb 86 35 and and CC cord-017784-4r3fpmlb 86 36 Coxiella Coxiella NNP cord-017784-4r3fpmlb 86 37 burnetii burnetii NNP cord-017784-4r3fpmlb 86 38 ) ) -RRB- cord-017784-4r3fpmlb 86 39 were be VBD cord-017784-4r3fpmlb 86 40 more more RBR cord-017784-4r3fpmlb 86 41 frequent frequent JJ cord-017784-4r3fpmlb 86 42 in in IN cord-017784-4r3fpmlb 86 43 younger young JJR cord-017784-4r3fpmlb 86 44 patient patient JJ cord-017784-4r3fpmlb 86 45 [ [ -LRB- cord-017784-4r3fpmlb 86 46 22 22 CD cord-017784-4r3fpmlb 86 47 ] ] -RRB- cord-017784-4r3fpmlb 86 48 . . . cord-017784-4r3fpmlb 87 1 Among among IN cord-017784-4r3fpmlb 87 2 the the DT cord-017784-4r3fpmlb 87 3 atypical atypical JJ cord-017784-4r3fpmlb 87 4 bacteria bacteria NNS cord-017784-4r3fpmlb 87 5 , , , cord-017784-4r3fpmlb 87 6 Chlamydophila Chlamydophila NNP cord-017784-4r3fpmlb 87 7 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 87 8 is be VBZ cord-017784-4r3fpmlb 87 9 the the DT cord-017784-4r3fpmlb 87 10 most most RBS cord-017784-4r3fpmlb 87 11 common common JJ cord-017784-4r3fpmlb 87 12 agent agent NN cord-017784-4r3fpmlb 87 13 , , , cord-017784-4r3fpmlb 87 14 while while IN cord-017784-4r3fpmlb 87 15 Mycoplasma Mycoplasma NNP cord-017784-4r3fpmlb 87 16 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 87 17 is be VBZ cord-017784-4r3fpmlb 87 18 less less RBR cord-017784-4r3fpmlb 87 19 frequently frequently RB cord-017784-4r3fpmlb 87 20 associated associate VBN cord-017784-4r3fpmlb 87 21 with with IN cord-017784-4r3fpmlb 87 22 CAP cap NN cord-017784-4r3fpmlb 87 23 in in IN cord-017784-4r3fpmlb 87 24 this this DT cord-017784-4r3fpmlb 87 25 age age NN cord-017784-4r3fpmlb 87 26 group group NN cord-017784-4r3fpmlb 87 27 . . . cord-017784-4r3fpmlb 88 1 Although although IN cord-017784-4r3fpmlb 88 2 uncommon uncommon JJ cord-017784-4r3fpmlb 88 3 , , , cord-017784-4r3fpmlb 88 4 Legionella Legionella NNP cord-017784-4r3fpmlb 88 5 pneumophila pneumophila NN cord-017784-4r3fpmlb 88 6 should should MD cord-017784-4r3fpmlb 88 7 be be VB cord-017784-4r3fpmlb 88 8 considered consider VBN cord-017784-4r3fpmlb 88 9 in in IN cord-017784-4r3fpmlb 88 10 elderly elderly JJ cord-017784-4r3fpmlb 88 11 adults adult NNS cord-017784-4r3fpmlb 88 12 presenting present VBG cord-017784-4r3fpmlb 88 13 with with IN cord-017784-4r3fpmlb 88 14 atypical atypical JJ cord-017784-4r3fpmlb 88 15 symptoms symptom NNS cord-017784-4r3fpmlb 88 16 ( ( -LRB- cord-017784-4r3fpmlb 88 17 e.g. e.g. RB cord-017784-4r3fpmlb 88 18 , , , cord-017784-4r3fpmlb 88 19 headache headache NN cord-017784-4r3fpmlb 88 20 , , , cord-017784-4r3fpmlb 88 21 weakness weakness NN cord-017784-4r3fpmlb 88 22 , , , cord-017784-4r3fpmlb 88 23 altered alter VBN cord-017784-4r3fpmlb 88 24 mental mental JJ cord-017784-4r3fpmlb 88 25 status status NN cord-017784-4r3fpmlb 88 26 , , , cord-017784-4r3fpmlb 88 27 gastrointestinal gastrointestinal JJ cord-017784-4r3fpmlb 88 28 disturbances disturbance NNS cord-017784-4r3fpmlb 88 29 , , , cord-017784-4r3fpmlb 88 30 or or CC cord-017784-4r3fpmlb 88 31 bradycardia bradycardia JJ cord-017784-4r3fpmlb 88 32 in in IN cord-017784-4r3fpmlb 88 33 the the DT cord-017784-4r3fpmlb 88 34 setting setting NN cord-017784-4r3fpmlb 88 35 of of IN cord-017784-4r3fpmlb 88 36 a a DT cord-017784-4r3fpmlb 88 37 paucity paucity NN cord-017784-4r3fpmlb 88 38 of of IN cord-017784-4r3fpmlb 88 39 respiratory respiratory JJ cord-017784-4r3fpmlb 88 40 symptoms symptom NNS cord-017784-4r3fpmlb 88 41 ) ) -RRB- cord-017784-4r3fpmlb 88 42 or or CC cord-017784-4r3fpmlb 88 43 those those DT cord-017784-4r3fpmlb 88 44 with with IN cord-017784-4r3fpmlb 88 45 severe severe JJ cord-017784-4r3fpmlb 88 46 pneumonia pneumonia NN cord-017784-4r3fpmlb 88 47 . . . cord-017784-4r3fpmlb 89 1 Gram gram NN cord-017784-4r3fpmlb 89 2 - - HYPH cord-017784-4r3fpmlb 89 3 negative negative JJ cord-017784-4r3fpmlb 89 4 organisms organism NNS cord-017784-4r3fpmlb 89 5 are be VBP cord-017784-4r3fpmlb 89 6 an an DT cord-017784-4r3fpmlb 89 7 uncommon uncommon JJ cord-017784-4r3fpmlb 89 8 cause cause NN cord-017784-4r3fpmlb 89 9 of of IN cord-017784-4r3fpmlb 89 10 CAP cap NN cord-017784-4r3fpmlb 89 11 . . . cord-017784-4r3fpmlb 90 1 However however RB cord-017784-4r3fpmlb 90 2 , , , cord-017784-4r3fpmlb 90 3 in in IN cord-017784-4r3fpmlb 90 4 severely severely RB cord-017784-4r3fpmlb 90 5 debilitated debilitated JJ cord-017784-4r3fpmlb 90 6 or or CC cord-017784-4r3fpmlb 90 7 chronically chronically RB cord-017784-4r3fpmlb 90 8 ill ill JJ cord-017784-4r3fpmlb 90 9 elderly elderly JJ cord-017784-4r3fpmlb 90 10 patients patient NNS cord-017784-4r3fpmlb 90 11 from from IN cord-017784-4r3fpmlb 90 12 the the DT cord-017784-4r3fpmlb 90 13 community community NN cord-017784-4r3fpmlb 90 14 , , , cord-017784-4r3fpmlb 90 15 a a DT cord-017784-4r3fpmlb 90 16 high high JJ cord-017784-4r3fpmlb 90 17 index index NN cord-017784-4r3fpmlb 90 18 of of IN cord-017784-4r3fpmlb 90 19 suspicion suspicion NN cord-017784-4r3fpmlb 90 20 for for IN cord-017784-4r3fpmlb 90 21 Gram gram NN cord-017784-4r3fpmlb 90 22 - - HYPH cord-017784-4r3fpmlb 90 23 negative negative JJ cord-017784-4r3fpmlb 90 24 bacilli bacilli NN cord-017784-4r3fpmlb 90 25 may may MD cord-017784-4r3fpmlb 90 26 be be VB cord-017784-4r3fpmlb 90 27 warranted warrant VBN cord-017784-4r3fpmlb 90 28 , , , cord-017784-4r3fpmlb 90 29 especially especially RB cord-017784-4r3fpmlb 90 30 in in IN cord-017784-4r3fpmlb 90 31 those those DT cord-017784-4r3fpmlb 90 32 who who WP cord-017784-4r3fpmlb 90 33 fail fail VBP cord-017784-4r3fpmlb 90 34 to to TO cord-017784-4r3fpmlb 90 35 improve improve VB cord-017784-4r3fpmlb 90 36 on on IN cord-017784-4r3fpmlb 90 37 standard standard JJ cord-017784-4r3fpmlb 90 38 therapy therapy NN cord-017784-4r3fpmlb 90 39 . . . cord-017784-4r3fpmlb 91 1 The the DT cord-017784-4r3fpmlb 91 2 probability probability NN cord-017784-4r3fpmlb 91 3 of of IN cord-017784-4r3fpmlb 91 4 MRSA MRSA NNP cord-017784-4r3fpmlb 91 5 in in IN cord-017784-4r3fpmlb 91 6 patients patient NNS cord-017784-4r3fpmlb 91 7 hospitalized hospitalize VBN cord-017784-4r3fpmlb 91 8 in in IN cord-017784-4r3fpmlb 91 9 conventional conventional JJ cord-017784-4r3fpmlb 91 10 wards ward NNS cord-017784-4r3fpmlb 91 11 is be VBZ cord-017784-4r3fpmlb 91 12 low low JJ cord-017784-4r3fpmlb 91 13 being be VBG cord-017784-4r3fpmlb 91 14 more more RBR cord-017784-4r3fpmlb 91 15 frequent frequent JJ cord-017784-4r3fpmlb 91 16 in in IN cord-017784-4r3fpmlb 91 17 severe severe JJ cord-017784-4r3fpmlb 91 18 CAP cap NN cord-017784-4r3fpmlb 91 19 understood understand VBD cord-017784-4r3fpmlb 91 20 as as IN cord-017784-4r3fpmlb 91 21 the the DT cord-017784-4r3fpmlb 91 22 need need NN cord-017784-4r3fpmlb 91 23 for for IN cord-017784-4r3fpmlb 91 24 admission admission NN cord-017784-4r3fpmlb 91 25 in in IN cord-017784-4r3fpmlb 91 26 an an DT cord-017784-4r3fpmlb 91 27 intensive intensive JJ cord-017784-4r3fpmlb 91 28 care care NN cord-017784-4r3fpmlb 91 29 unit unit NN cord-017784-4r3fpmlb 91 30 ( ( -LRB- cord-017784-4r3fpmlb 91 31 ICU ICU NNP cord-017784-4r3fpmlb 91 32 ) ) -RRB- cord-017784-4r3fpmlb 91 33 . . . cord-017784-4r3fpmlb 92 1 Thus thus RB cord-017784-4r3fpmlb 92 2 , , , cord-017784-4r3fpmlb 92 3 in in IN cord-017784-4r3fpmlb 92 4 the the DT cord-017784-4r3fpmlb 92 5 presence presence NN cord-017784-4r3fpmlb 92 6 of of IN cord-017784-4r3fpmlb 92 7 less less JJR cord-017784-4r3fpmlb 92 8 than than IN cord-017784-4r3fpmlb 92 9 two two CD cord-017784-4r3fpmlb 92 10 factors factor NNS cord-017784-4r3fpmlb 92 11 of of IN cord-017784-4r3fpmlb 92 12 multiresistance multiresistance NN cord-017784-4r3fpmlb 92 13 ( ( -LRB- cord-017784-4r3fpmlb 92 14 severe severe JJ cord-017784-4r3fpmlb 92 15 pneumonia pneumonia NN cord-017784-4r3fpmlb 92 16 , , , cord-017784-4r3fpmlb 92 17 hospitalization hospitalization NN cord-017784-4r3fpmlb 92 18 in in IN cord-017784-4r3fpmlb 92 19 the the DT cord-017784-4r3fpmlb 92 20 previous previous JJ cord-017784-4r3fpmlb 92 21 90 90 CD cord-017784-4r3fpmlb 92 22 days day NNS cord-017784-4r3fpmlb 92 23 , , , cord-017784-4r3fpmlb 92 24 living live VBG cord-017784-4r3fpmlb 92 25 in in IN cord-017784-4r3fpmlb 92 26 a a DT cord-017784-4r3fpmlb 92 27 residence residence NN cord-017784-4r3fpmlb 92 28 , , , cord-017784-4r3fpmlb 92 29 severe severe JJ cord-017784-4r3fpmlb 92 30 basal basal NN cord-017784-4r3fpmlb 92 31 dependence dependence NN cord-017784-4r3fpmlb 92 32 for for IN cord-017784-4r3fpmlb 92 33 basic basic JJ cord-017784-4r3fpmlb 92 34 daily daily JJ cord-017784-4r3fpmlb 92 35 life life NN cord-017784-4r3fpmlb 92 36 activities activity NNS cord-017784-4r3fpmlb 92 37 , , , cord-017784-4r3fpmlb 92 38 immunodepression immunodepression NN cord-017784-4r3fpmlb 92 39 , , , cord-017784-4r3fpmlb 92 40 or or CC cord-017784-4r3fpmlb 92 41 the the DT cord-017784-4r3fpmlb 92 42 taking taking NN cord-017784-4r3fpmlb 92 43 of of IN cord-017784-4r3fpmlb 92 44 antibiotics antibiotic NNS cord-017784-4r3fpmlb 92 45 in in IN cord-017784-4r3fpmlb 92 46 the the DT cord-017784-4r3fpmlb 92 47 previous previous JJ cord-017784-4r3fpmlb 92 48 6 6 CD cord-017784-4r3fpmlb 92 49 months month NNS cord-017784-4r3fpmlb 92 50 ) ) -RRB- cord-017784-4r3fpmlb 93 1 coverage coverage NN cord-017784-4r3fpmlb 93 2 against against IN cord-017784-4r3fpmlb 93 3 MRSA MRSA NNP cord-017784-4r3fpmlb 93 4 should should MD cord-017784-4r3fpmlb 93 5 be be VB cord-017784-4r3fpmlb 93 6 included include VBN cord-017784-4r3fpmlb 93 7 if if IN cord-017784-4r3fpmlb 93 8 the the DT cord-017784-4r3fpmlb 93 9 patient patient NN cord-017784-4r3fpmlb 93 10 presents present VBZ cord-017784-4r3fpmlb 93 11 severe severe JJ cord-017784-4r3fpmlb 93 12 disease disease NN cord-017784-4r3fpmlb 93 13 . . . cord-017784-4r3fpmlb 94 1 Pseudomonas Pseudomonas NNP cord-017784-4r3fpmlb 94 2 aeruginosa aeruginosa NN cord-017784-4r3fpmlb 94 3 is be VBZ cord-017784-4r3fpmlb 94 4 not not RB cord-017784-4r3fpmlb 94 5 a a DT cord-017784-4r3fpmlb 94 6 frequent frequent JJ cord-017784-4r3fpmlb 94 7 pathogen pathogen NN cord-017784-4r3fpmlb 94 8 in in IN cord-017784-4r3fpmlb 94 9 CAP cap NN cord-017784-4r3fpmlb 94 10 ; ; : cord-017784-4r3fpmlb 94 11 factors factor NNS cord-017784-4r3fpmlb 94 12 increasing increase VBG cord-017784-4r3fpmlb 94 13 the the DT cord-017784-4r3fpmlb 94 14 likelihood likelihood NN cord-017784-4r3fpmlb 94 15 for for IN cord-017784-4r3fpmlb 94 16 Pseudomonas Pseudomonas NNP cord-017784-4r3fpmlb 94 17 infection infection NN cord-017784-4r3fpmlb 94 18 are be VBP cord-017784-4r3fpmlb 94 19 structural structural JJ cord-017784-4r3fpmlb 94 20 lung lung NN cord-017784-4r3fpmlb 94 21 disease disease NN cord-017784-4r3fpmlb 94 22 such such JJ cord-017784-4r3fpmlb 94 23 as as IN cord-017784-4r3fpmlb 94 24 bronchiectasis bronchiectasis NN cord-017784-4r3fpmlb 94 25 or or CC cord-017784-4r3fpmlb 94 26 severe severe JJ cord-017784-4r3fpmlb 94 27 COPD COPD NNP cord-017784-4r3fpmlb 94 28 with with IN cord-017784-4r3fpmlb 94 29 FEV1 FEV1 NNP cord-017784-4r3fpmlb 94 30 < < XX cord-017784-4r3fpmlb 94 31 35 35 CD cord-017784-4r3fpmlb 94 32 % % NN cord-017784-4r3fpmlb 94 33 , , , cord-017784-4r3fpmlb 94 34 severe severe JJ cord-017784-4r3fpmlb 94 35 pneumonia pneumonia NN cord-017784-4r3fpmlb 94 36 requiring require VBG cord-017784-4r3fpmlb 94 37 ICU ICU NNP cord-017784-4r3fpmlb 94 38 admission admission NN cord-017784-4r3fpmlb 94 39 , , , cord-017784-4r3fpmlb 94 40 frequent frequent JJ cord-017784-4r3fpmlb 94 41 or or CC cord-017784-4r3fpmlb 94 42 recent recent JJ cord-017784-4r3fpmlb 94 43 use use NN cord-017784-4r3fpmlb 94 44 of of IN cord-017784-4r3fpmlb 94 45 antibiotics antibiotic NNS cord-017784-4r3fpmlb 94 46 , , , cord-017784-4r3fpmlb 94 47 recent recent JJ cord-017784-4r3fpmlb 94 48 hospital hospital NN cord-017784-4r3fpmlb 94 49 admission admission NN cord-017784-4r3fpmlb 94 50 and and CC cord-017784-4r3fpmlb 94 51 steroid steroid NN cord-017784-4r3fpmlb 94 52 use use NN cord-017784-4r3fpmlb 94 53 . . . cord-017784-4r3fpmlb 95 1 Aspiration Aspiration NNP cord-017784-4r3fpmlb 95 2 pneumonia pneumonia NN cord-017784-4r3fpmlb 95 3 refers refer VBZ cord-017784-4r3fpmlb 95 4 to to IN cord-017784-4r3fpmlb 95 5 an an DT cord-017784-4r3fpmlb 95 6 infection infection NN cord-017784-4r3fpmlb 95 7 that that WDT cord-017784-4r3fpmlb 95 8 develops develop VBZ cord-017784-4r3fpmlb 95 9 after after IN cord-017784-4r3fpmlb 95 10 the the DT cord-017784-4r3fpmlb 95 11 entrance entrance NN cord-017784-4r3fpmlb 95 12 of of IN cord-017784-4r3fpmlb 95 13 pathologic pathologic JJ cord-017784-4r3fpmlb 95 14 oropharyngeal oropharyngeal JJ cord-017784-4r3fpmlb 95 15 microbes microbe NNS cord-017784-4r3fpmlb 95 16 into into IN cord-017784-4r3fpmlb 95 17 the the DT cord-017784-4r3fpmlb 95 18 lung lung NN cord-017784-4r3fpmlb 95 19 . . . cord-017784-4r3fpmlb 96 1 Major major JJ cord-017784-4r3fpmlb 96 2 risk risk NN cord-017784-4r3fpmlb 96 3 factors factor NNS cord-017784-4r3fpmlb 96 4 for for IN cord-017784-4r3fpmlb 96 5 aspiration aspiration NN cord-017784-4r3fpmlb 96 6 include include VBP cord-017784-4r3fpmlb 96 7 depressed depressed JJ cord-017784-4r3fpmlb 96 8 consciousness consciousness NN cord-017784-4r3fpmlb 96 9 , , , cord-017784-4r3fpmlb 96 10 compromised compromise VBN cord-017784-4r3fpmlb 96 11 airway airway NN cord-017784-4r3fpmlb 96 12 defenses defense NNS cord-017784-4r3fpmlb 96 13 , , , cord-017784-4r3fpmlb 96 14 dysphagia dysphagia NN cord-017784-4r3fpmlb 96 15 , , , cord-017784-4r3fpmlb 96 16 gastroesophageal gastroesophageal JJ cord-017784-4r3fpmlb 96 17 reflux reflux NN cord-017784-4r3fpmlb 96 18 disease disease NN cord-017784-4r3fpmlb 96 19 , , , cord-017784-4r3fpmlb 96 20 and and CC cord-017784-4r3fpmlb 96 21 recurrent recurrent JJ cord-017784-4r3fpmlb 96 22 vomiting vomiting NN cord-017784-4r3fpmlb 96 23 . . . cord-017784-4r3fpmlb 97 1 Most Most JJS cord-017784-4r3fpmlb 97 2 patients patient NNS cord-017784-4r3fpmlb 97 3 with with IN cord-017784-4r3fpmlb 97 4 communityacquired communityacquired JJ cord-017784-4r3fpmlb 97 5 aspiration aspiration NN cord-017784-4r3fpmlb 97 6 pneumonia pneumonia NN cord-017784-4r3fpmlb 97 7 have have VBP cord-017784-4r3fpmlb 97 8 a a DT cord-017784-4r3fpmlb 97 9 mixed mixed JJ cord-017784-4r3fpmlb 97 10 infection infection NN cord-017784-4r3fpmlb 97 11 with with IN cord-017784-4r3fpmlb 97 12 anaerobic anaerobic JJ cord-017784-4r3fpmlb 97 13 and and CC cord-017784-4r3fpmlb 97 14 aerobic aerobic JJ cord-017784-4r3fpmlb 97 15 bacteria bacteria NNS cord-017784-4r3fpmlb 97 16 , , , cord-017784-4r3fpmlb 97 17 whereas whereas IN cord-017784-4r3fpmlb 97 18 those those DT cord-017784-4r3fpmlb 97 19 with with IN cord-017784-4r3fpmlb 97 20 hospital hospital NN cord-017784-4r3fpmlb 97 21 - - HYPH cord-017784-4r3fpmlb 97 22 acquired acquire VBN cord-017784-4r3fpmlb 97 23 pneumonia pneumonia NN cord-017784-4r3fpmlb 97 24 will will MD cord-017784-4r3fpmlb 97 25 more more RBR cord-017784-4r3fpmlb 97 26 likely likely RB cord-017784-4r3fpmlb 97 27 have have VB cord-017784-4r3fpmlb 97 28 Gram gram NN cord-017784-4r3fpmlb 97 29 - - HYPH cord-017784-4r3fpmlb 97 30 negative negative JJ cord-017784-4r3fpmlb 97 31 infections infection NNS cord-017784-4r3fpmlb 97 32 , , , cord-017784-4r3fpmlb 97 33 including include VBG cord-017784-4r3fpmlb 97 34 Pseudomonas Pseudomonas NNP cord-017784-4r3fpmlb 97 35 aeruginosa aeruginosa NN cord-017784-4r3fpmlb 97 36 [ [ -LRB- cord-017784-4r3fpmlb 97 37 23 23 CD cord-017784-4r3fpmlb 97 38 ] ] -RRB- cord-017784-4r3fpmlb 97 39 . . . cord-017784-4r3fpmlb 98 1 In in IN cord-017784-4r3fpmlb 98 2 regard regard NN cord-017784-4r3fpmlb 98 3 to to IN cord-017784-4r3fpmlb 98 4 viral viral JJ cord-017784-4r3fpmlb 98 5 etiology etiology NN cord-017784-4r3fpmlb 98 6 , , , cord-017784-4r3fpmlb 98 7 the the DT cord-017784-4r3fpmlb 98 8 influenza influenza NN cord-017784-4r3fpmlb 98 9 virus virus NN cord-017784-4r3fpmlb 98 10 and and CC cord-017784-4r3fpmlb 98 11 respiratory respiratory JJ cord-017784-4r3fpmlb 98 12 syncytial syncytial JJ cord-017784-4r3fpmlb 98 13 virus virus NN cord-017784-4r3fpmlb 98 14 are be VBP cord-017784-4r3fpmlb 98 15 most most RBS cord-017784-4r3fpmlb 98 16 important important JJ cord-017784-4r3fpmlb 98 17 cause cause NN cord-017784-4r3fpmlb 98 18 of of IN cord-017784-4r3fpmlb 98 19 pneumonia pneumonia NN cord-017784-4r3fpmlb 98 20 in in IN cord-017784-4r3fpmlb 98 21 the the DT cord-017784-4r3fpmlb 98 22 elderly elderly JJ cord-017784-4r3fpmlb 98 23 , , , cord-017784-4r3fpmlb 98 24 often often RB cord-017784-4r3fpmlb 98 25 within within IN cord-017784-4r3fpmlb 98 26 the the DT cord-017784-4r3fpmlb 98 27 context context NN cord-017784-4r3fpmlb 98 28 of of IN cord-017784-4r3fpmlb 98 29 epidemic epidemic NN cord-017784-4r3fpmlb 98 30 outbreaks outbreak NNS cord-017784-4r3fpmlb 98 31 and and CC cord-017784-4r3fpmlb 98 32 may may MD cord-017784-4r3fpmlb 98 33 cause cause VB cord-017784-4r3fpmlb 98 34 both both DT cord-017784-4r3fpmlb 98 35 viral viral JJ cord-017784-4r3fpmlb 98 36 primary primary JJ cord-017784-4r3fpmlb 98 37 pneumonias pneumonia NNS cord-017784-4r3fpmlb 98 38 such such JJ cord-017784-4r3fpmlb 98 39 as as IN cord-017784-4r3fpmlb 98 40 bacterial bacterial JJ cord-017784-4r3fpmlb 98 41 superinfection superinfection NN cord-017784-4r3fpmlb 98 42 by by IN cord-017784-4r3fpmlb 98 43 S. S. NNP cord-017784-4r3fpmlb 98 44 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 98 45 , , , cord-017784-4r3fpmlb 98 46 S. S. NNP cord-017784-4r3fpmlb 98 47 aureus aureus NN cord-017784-4r3fpmlb 98 48 , , , cord-017784-4r3fpmlb 98 49 and and CC cord-017784-4r3fpmlb 98 50 Haemophilus haemophilus JJ cord-017784-4r3fpmlb 98 51 influenzae influenzae NN cord-017784-4r3fpmlb 98 52 . . . cord-017784-4r3fpmlb 99 1 ( ( -LRB- cord-017784-4r3fpmlb 99 2 Table table NN cord-017784-4r3fpmlb 99 3 5 5 CD cord-017784-4r3fpmlb 99 4 . . . cord-017784-4r3fpmlb 99 5 _SP cord-017784-4r3fpmlb 100 1 Antimicrobials antimicrobial NNS cord-017784-4r3fpmlb 100 2 are be VBP cord-017784-4r3fpmlb 100 3 the the DT cord-017784-4r3fpmlb 100 4 cornerstone cornerstone NN cord-017784-4r3fpmlb 100 5 of of IN cord-017784-4r3fpmlb 100 6 therapy therapy NN cord-017784-4r3fpmlb 100 7 for for IN cord-017784-4r3fpmlb 100 8 CAP cap NN cord-017784-4r3fpmlb 100 9 in in IN cord-017784-4r3fpmlb 100 10 any any DT cord-017784-4r3fpmlb 100 11 population population NN cord-017784-4r3fpmlb 100 12 , , , cord-017784-4r3fpmlb 100 13 but but CC cord-017784-4r3fpmlb 100 14 limited limited JJ cord-017784-4r3fpmlb 100 15 data datum NNS cord-017784-4r3fpmlb 100 16 are be VBP cord-017784-4r3fpmlb 100 17 available available JJ cord-017784-4r3fpmlb 100 18 regarding regard VBG cord-017784-4r3fpmlb 100 19 the the DT cord-017784-4r3fpmlb 100 20 specific specific JJ cord-017784-4r3fpmlb 100 21 treatments treatment NNS cord-017784-4r3fpmlb 100 22 for for IN cord-017784-4r3fpmlb 100 23 elderly elderly JJ cord-017784-4r3fpmlb 100 24 patients patient NNS cord-017784-4r3fpmlb 100 25 . . . cord-017784-4r3fpmlb 101 1 The the DT cord-017784-4r3fpmlb 101 2 only only JJ cord-017784-4r3fpmlb 101 3 guidelines guideline NNS cord-017784-4r3fpmlb 101 4 for for IN cord-017784-4r3fpmlb 101 5 the the DT cord-017784-4r3fpmlb 101 6 management management NN cord-017784-4r3fpmlb 101 7 of of IN cord-017784-4r3fpmlb 101 8 community community NN cord-017784-4r3fpmlb 101 9 - - HYPH cord-017784-4r3fpmlb 101 10 acquired acquire VBN cord-017784-4r3fpmlb 101 11 pneumonia pneumonia NN cord-017784-4r3fpmlb 101 12 in in IN cord-017784-4r3fpmlb 101 13 the the DT cord-017784-4r3fpmlb 101 14 elderly elderly JJ cord-017784-4r3fpmlb 101 15 patient patient NN cord-017784-4r3fpmlb 101 16 are be VBP cord-017784-4r3fpmlb 101 17 published publish VBN cord-017784-4r3fpmlb 101 18 in in IN cord-017784-4r3fpmlb 101 19 the the DT cord-017784-4r3fpmlb 101 20 year year NN cord-017784-4r3fpmlb 101 21 2014 2014 CD cord-017784-4r3fpmlb 101 22 in in IN cord-017784-4r3fpmlb 101 23 Spanish Spanish NNP cord-017784-4r3fpmlb 101 24 [ [ -LRB- cord-017784-4r3fpmlb 101 25 24 24 CD cord-017784-4r3fpmlb 101 26 ] ] -RRB- cord-017784-4r3fpmlb 101 27 . . . cord-017784-4r3fpmlb 102 1 Initial initial JJ cord-017784-4r3fpmlb 102 2 antibiotic antibiotic JJ cord-017784-4r3fpmlb 102 3 selection selection NN cord-017784-4r3fpmlb 102 4 for for IN cord-017784-4r3fpmlb 102 5 CAP CAP NNP cord-017784-4r3fpmlb 102 6 is be VBZ cord-017784-4r3fpmlb 102 7 often often RB cord-017784-4r3fpmlb 102 8 empirical empirical JJ cord-017784-4r3fpmlb 102 9 , , , cord-017784-4r3fpmlb 102 10 as as IN cord-017784-4r3fpmlb 102 11 the the DT cord-017784-4r3fpmlb 102 12 causative causative JJ cord-017784-4r3fpmlb 102 13 pathogen pathogen NN cord-017784-4r3fpmlb 102 14 can can MD cord-017784-4r3fpmlb 102 15 not not RB cord-017784-4r3fpmlb 102 16 be be VB cord-017784-4r3fpmlb 102 17 predicted predict VBN cord-017784-4r3fpmlb 102 18 from from IN cord-017784-4r3fpmlb 102 19 clinical clinical JJ cord-017784-4r3fpmlb 102 20 laboratory laboratory NN cord-017784-4r3fpmlb 102 21 or or CC cord-017784-4r3fpmlb 102 22 radiological radiological JJ cord-017784-4r3fpmlb 102 23 findings finding NNS cord-017784-4r3fpmlb 102 24 and and CC cord-017784-4r3fpmlb 102 25 therapy therapy NN cord-017784-4r3fpmlb 102 26 must must MD cord-017784-4r3fpmlb 102 27 be be VB cord-017784-4r3fpmlb 102 28 started start VBN cord-017784-4r3fpmlb 102 29 swiftly swiftly RB cord-017784-4r3fpmlb 102 30 as as RB cord-017784-4r3fpmlb 102 31 rapid rapid JJ cord-017784-4r3fpmlb 102 32 antibiotic antibiotic JJ cord-017784-4r3fpmlb 102 33 delivery delivery NN cord-017784-4r3fpmlb 102 34 is be VBZ cord-017784-4r3fpmlb 102 35 associated associate VBN cord-017784-4r3fpmlb 102 36 with with IN cord-017784-4r3fpmlb 102 37 a a DT cord-017784-4r3fpmlb 102 38 better well JJR cord-017784-4r3fpmlb 102 39 outcome outcome NN cord-017784-4r3fpmlb 102 40 [ [ -LRB- cord-017784-4r3fpmlb 102 41 25 25 CD cord-017784-4r3fpmlb 102 42 ] ] -RRB- cord-017784-4r3fpmlb 102 43 . . . cord-017784-4r3fpmlb 103 1 Empirical empirical JJ cord-017784-4r3fpmlb 103 2 antimicrobial antimicrobial JJ cord-017784-4r3fpmlb 103 3 therapy therapy NN cord-017784-4r3fpmlb 103 4 must must MD cord-017784-4r3fpmlb 103 5 include include VB cord-017784-4r3fpmlb 103 6 coverage coverage NN cord-017784-4r3fpmlb 103 7 for for IN cord-017784-4r3fpmlb 103 8 the the DT cord-017784-4r3fpmlb 103 9 most most RBS cord-017784-4r3fpmlb 103 10 prevalent prevalent JJ cord-017784-4r3fpmlb 103 11 pathogens pathogen NNS cord-017784-4r3fpmlb 103 12 and and CC cord-017784-4r3fpmlb 103 13 should should MD cord-017784-4r3fpmlb 103 14 be be VB cord-017784-4r3fpmlb 103 15 based base VBN cord-017784-4r3fpmlb 103 16 on on IN cord-017784-4r3fpmlb 103 17 several several JJ cord-017784-4r3fpmlb 103 18 aspects aspect NNS cord-017784-4r3fpmlb 103 19 such such JJ cord-017784-4r3fpmlb 103 20 as as IN cord-017784-4r3fpmlb 103 21 the the DT cord-017784-4r3fpmlb 103 22 severity severity NN cord-017784-4r3fpmlb 103 23 of of IN cord-017784-4r3fpmlb 103 24 diseases disease NNS cord-017784-4r3fpmlb 103 25 , , , cord-017784-4r3fpmlb 103 26 local local JJ cord-017784-4r3fpmlb 103 27 patterns pattern NNS cord-017784-4r3fpmlb 103 28 of of IN cord-017784-4r3fpmlb 103 29 antimicrobial antimicrobial JJ cord-017784-4r3fpmlb 103 30 resistances resistance NNS cord-017784-4r3fpmlb 103 31 , , , cord-017784-4r3fpmlb 103 32 multi multi JJ cord-017784-4r3fpmlb 103 33 - - JJ cord-017784-4r3fpmlb 103 34 drug drug JJ cord-017784-4r3fpmlb 103 35 - - HYPH cord-017784-4r3fpmlb 103 36 resistant resistant JJ cord-017784-4r3fpmlb 103 37 risk risk NN cord-017784-4r3fpmlb 103 38 factors factor NNS cord-017784-4r3fpmlb 103 39 , , , cord-017784-4r3fpmlb 103 40 and and CC cord-017784-4r3fpmlb 103 41 drug drug NN cord-017784-4r3fpmlb 103 42 allergies allergy NNS cord-017784-4r3fpmlb 103 43 . . . cord-017784-4r3fpmlb 104 1 International international JJ cord-017784-4r3fpmlb 104 2 guidelines guideline NNS cord-017784-4r3fpmlb 104 3 agree agree VBP cord-017784-4r3fpmlb 104 4 that that IN cord-017784-4r3fpmlb 104 5 patients patient NNS cord-017784-4r3fpmlb 104 6 hospitalized hospitalize VBN cord-017784-4r3fpmlb 104 7 with with IN cord-017784-4r3fpmlb 104 8 non non JJ cord-017784-4r3fpmlb 104 9 - - JJ cord-017784-4r3fpmlb 104 10 severe severe JJ cord-017784-4r3fpmlb 104 11 CAP cap NN cord-017784-4r3fpmlb 104 12 should should MD cord-017784-4r3fpmlb 104 13 be be VB cord-017784-4r3fpmlb 104 14 started start VBN cord-017784-4r3fpmlb 104 15 on on IN cord-017784-4r3fpmlb 104 16 empirical empirical JJ cord-017784-4r3fpmlb 104 17 combination combination NN cord-017784-4r3fpmlb 104 18 therapy therapy NN cord-017784-4r3fpmlb 104 19 using use VBG cord-017784-4r3fpmlb 104 20 a a DT cord-017784-4r3fpmlb 104 21 β β NN cord-017784-4r3fpmlb 104 22 - - HYPH cord-017784-4r3fpmlb 104 23 lactam lactam NNP cord-017784-4r3fpmlb 104 24 plus plus CC cord-017784-4r3fpmlb 104 25 a a DT cord-017784-4r3fpmlb 104 26 macrolide macrolide NN cord-017784-4r3fpmlb 104 27 or or CC cord-017784-4r3fpmlb 104 28 a a DT cord-017784-4r3fpmlb 104 29 respiratory respiratory JJ cord-017784-4r3fpmlb 104 30 fluoroquinolone fluoroquinolone NN cord-017784-4r3fpmlb 104 31 alone alone RB cord-017784-4r3fpmlb 104 32 ( ( -LRB- cord-017784-4r3fpmlb 104 33 levofloxacin levofloxacin NNP cord-017784-4r3fpmlb 104 34 , , , cord-017784-4r3fpmlb 104 35 moxifloxacin moxifloxacin NNS cord-017784-4r3fpmlb 104 36 , , , cord-017784-4r3fpmlb 104 37 and and CC cord-017784-4r3fpmlb 104 38 gatifloxacin gatifloxacin NNP cord-017784-4r3fpmlb 104 39 ) ) -RRB- cord-017784-4r3fpmlb 104 40 . . . cord-017784-4r3fpmlb 105 1 The the DT cord-017784-4r3fpmlb 105 2 respiratory respiratory JJ cord-017784-4r3fpmlb 105 3 quinolones quinolone NNS cord-017784-4r3fpmlb 105 4 are be VBP cord-017784-4r3fpmlb 105 5 quinolones quinolone NNS cord-017784-4r3fpmlb 105 6 that that WDT cord-017784-4r3fpmlb 105 7 are be VBP cord-017784-4r3fpmlb 105 8 highly highly RB cord-017784-4r3fpmlb 105 9 active active JJ cord-017784-4r3fpmlb 105 10 against against IN cord-017784-4r3fpmlb 105 11 both both CC cord-017784-4r3fpmlb 105 12 the the DT cord-017784-4r3fpmlb 105 13 typical typical JJ cord-017784-4r3fpmlb 105 14 and and CC cord-017784-4r3fpmlb 105 15 atypical atypical JJ cord-017784-4r3fpmlb 105 16 respiratory respiratory JJ cord-017784-4r3fpmlb 105 17 pathogens pathogen NNS cord-017784-4r3fpmlb 105 18 causing cause VBG cord-017784-4r3fpmlb 105 19 CAP cap NN cord-017784-4r3fpmlb 105 20 . . . cord-017784-4r3fpmlb 106 1 Because because IN cord-017784-4r3fpmlb 106 2 ciprofloxacin ciprofloxacin NN cord-017784-4r3fpmlb 106 3 is be VBZ cord-017784-4r3fpmlb 106 4 relatively relatively RB cord-017784-4r3fpmlb 106 5 inactive inactive JJ cord-017784-4r3fpmlb 106 6 against against IN cord-017784-4r3fpmlb 106 7 Streptococcus streptococcus NN cord-017784-4r3fpmlb 106 8 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 106 9 , , , cord-017784-4r3fpmlb 106 10 even even RB cord-017784-4r3fpmlb 106 11 though though IN cord-017784-4r3fpmlb 106 12 it -PRON- PRP cord-017784-4r3fpmlb 106 13 is be VBZ cord-017784-4r3fpmlb 106 14 active active JJ cord-017784-4r3fpmlb 106 15 against against IN cord-017784-4r3fpmlb 106 16 the the DT cord-017784-4r3fpmlb 106 17 atypical atypical JJ cord-017784-4r3fpmlb 106 18 pathogens pathogen NNS cord-017784-4r3fpmlb 106 19 , , , cord-017784-4r3fpmlb 106 20 it -PRON- PRP cord-017784-4r3fpmlb 106 21 is be VBZ cord-017784-4r3fpmlb 106 22 not not RB cord-017784-4r3fpmlb 106 23 termed term VBN cord-017784-4r3fpmlb 106 24 a a DT cord-017784-4r3fpmlb 106 25 " " `` cord-017784-4r3fpmlb 106 26 respiratory respiratory JJ cord-017784-4r3fpmlb 106 27 quinolone quinolone NN cord-017784-4r3fpmlb 106 28 . . . cord-017784-4r3fpmlb 106 29 " " '' cord-017784-4r3fpmlb 107 1 In in IN cord-017784-4r3fpmlb 107 2 patients patient NNS cord-017784-4r3fpmlb 107 3 with with IN cord-017784-4r3fpmlb 107 4 severe severe JJ cord-017784-4r3fpmlb 107 5 community community NN cord-017784-4r3fpmlb 107 6 - - HYPH cord-017784-4r3fpmlb 107 7 acquired acquire VBN cord-017784-4r3fpmlb 107 8 pneumonia pneumonia NN cord-017784-4r3fpmlb 107 9 ( ( -LRB- cord-017784-4r3fpmlb 107 10 admission admission NN cord-017784-4r3fpmlb 107 11 in in IN cord-017784-4r3fpmlb 107 12 ICU ICU NNP cord-017784-4r3fpmlb 107 13 or or CC cord-017784-4r3fpmlb 107 14 intermediate intermediate JJ cord-017784-4r3fpmlb 107 15 care care NN cord-017784-4r3fpmlb 107 16 ) ) -RRB- cord-017784-4r3fpmlb 107 17 , , , cord-017784-4r3fpmlb 107 18 the the DT cord-017784-4r3fpmlb 107 19 guidelines guideline NNS cord-017784-4r3fpmlb 107 20 recommend recommend VBP cord-017784-4r3fpmlb 107 21 a a DT cord-017784-4r3fpmlb 107 22 minimum minimum NN cord-017784-4r3fpmlb 107 23 of of IN cord-017784-4r3fpmlb 107 24 a a DT cord-017784-4r3fpmlb 107 25 β β NN cord-017784-4r3fpmlb 107 26 - - HYPH cord-017784-4r3fpmlb 107 27 lactam lactam NNS cord-017784-4r3fpmlb 107 28 plus plus CC cord-017784-4r3fpmlb 107 29 either either CC cord-017784-4r3fpmlb 107 30 a a DT cord-017784-4r3fpmlb 107 31 macrolide macrolide NN cord-017784-4r3fpmlb 107 32 or or CC cord-017784-4r3fpmlb 107 33 a a DT cord-017784-4r3fpmlb 107 34 quinolone quinolone NN cord-017784-4r3fpmlb 107 35 . . . cord-017784-4r3fpmlb 108 1 The the DT cord-017784-4r3fpmlb 108 2 combination combination NN cord-017784-4r3fpmlb 108 3 treatment treatment NN cord-017784-4r3fpmlb 108 4 offers offer VBZ cord-017784-4r3fpmlb 108 5 an an DT cord-017784-4r3fpmlb 108 6 advantage advantage NN cord-017784-4r3fpmlb 108 7 over over IN cord-017784-4r3fpmlb 108 8 monotherapy monotherapy NN cord-017784-4r3fpmlb 108 9 by by IN cord-017784-4r3fpmlb 108 10 expanding expand VBG cord-017784-4r3fpmlb 108 11 the the DT cord-017784-4r3fpmlb 108 12 antimicrobial antimicrobial JJ cord-017784-4r3fpmlb 108 13 coverage coverage NN cord-017784-4r3fpmlb 108 14 and and CC cord-017784-4r3fpmlb 108 15 probably probably RB cord-017784-4r3fpmlb 108 16 by by IN cord-017784-4r3fpmlb 108 17 immunomodulation immunomodulation NNP cord-017784-4r3fpmlb 108 18 ( ( -LRB- cord-017784-4r3fpmlb 108 19 macrolides macrolide NNS cord-017784-4r3fpmlb 108 20 , , , cord-017784-4r3fpmlb 108 21 quinolones quinolones NNP cord-017784-4r3fpmlb 108 22 ) ) -RRB- cord-017784-4r3fpmlb 108 23 . . . cord-017784-4r3fpmlb 109 1 In in IN cord-017784-4r3fpmlb 109 2 severe severe JJ cord-017784-4r3fpmlb 109 3 patients patient NNS cord-017784-4r3fpmlb 109 4 with with IN cord-017784-4r3fpmlb 109 5 risk risk NN cord-017784-4r3fpmlb 109 6 factors factor NNS cord-017784-4r3fpmlb 109 7 for for IN cord-017784-4r3fpmlb 109 8 MRSA MRSA NNP cord-017784-4r3fpmlb 109 9 vancomycin vancomycin NNS cord-017784-4r3fpmlb 109 10 or or CC cord-017784-4r3fpmlb 109 11 linezolid linezolid NN cord-017784-4r3fpmlb 109 12 should should MD cord-017784-4r3fpmlb 109 13 be be VB cord-017784-4r3fpmlb 109 14 added add VBN cord-017784-4r3fpmlb 109 15 . . . cord-017784-4r3fpmlb 110 1 CAP cap NN cord-017784-4r3fpmlb 110 2 patients patient NNS cord-017784-4r3fpmlb 110 3 with with IN cord-017784-4r3fpmlb 110 4 risk risk NN cord-017784-4r3fpmlb 110 5 factors factor NNS cord-017784-4r3fpmlb 110 6 for for IN cord-017784-4r3fpmlb 110 7 P. p. NN cord-017784-4r3fpmlb 110 8 aeruginosa aeruginosa NN cord-017784-4r3fpmlb 110 9 should should MD cord-017784-4r3fpmlb 110 10 receive receive VB cord-017784-4r3fpmlb 110 11 empirical empirical JJ cord-017784-4r3fpmlb 110 12 combination combination NN cord-017784-4r3fpmlb 110 13 therapy therapy NN cord-017784-4r3fpmlb 110 14 as as IN cord-017784-4r3fpmlb 110 15 an an DT cord-017784-4r3fpmlb 110 16 antipneumococcal antipneumococcal JJ cord-017784-4r3fpmlb 110 17 anti anti JJ cord-017784-4r3fpmlb 110 18 - - JJ cord-017784-4r3fpmlb 110 19 pseudomonal pseudomonal JJ cord-017784-4r3fpmlb 110 20 β β NN cord-017784-4r3fpmlb 110 21 - - HYPH cord-017784-4r3fpmlb 110 22 lactam lactam NNP cord-017784-4r3fpmlb 110 23 plus plus CC cord-017784-4r3fpmlb 110 24 either either CC cord-017784-4r3fpmlb 110 25 ciprofloxacin ciprofloxacin NN cord-017784-4r3fpmlb 110 26 or or CC cord-017784-4r3fpmlb 110 27 high high JJ cord-017784-4r3fpmlb 110 28 - - HYPH cord-017784-4r3fpmlb 110 29 dose dose NN cord-017784-4r3fpmlb 110 30 levofloxacin levofloxacin NNS cord-017784-4r3fpmlb 110 31 or or CC cord-017784-4r3fpmlb 110 32 the the DT cord-017784-4r3fpmlb 110 33 above above JJ cord-017784-4r3fpmlb 110 34 β β NN cord-017784-4r3fpmlb 110 35 - - HYPH cord-017784-4r3fpmlb 110 36 lactam lactam NNP cord-017784-4r3fpmlb 110 37 plus plus CC cord-017784-4r3fpmlb 110 38 an an DT cord-017784-4r3fpmlb 110 39 aminoglycoside aminoglycoside NN cord-017784-4r3fpmlb 110 40 and and CC cord-017784-4r3fpmlb 110 41 azithromycin azithromycin NN cord-017784-4r3fpmlb 110 42 is be VBZ cord-017784-4r3fpmlb 110 43 an an DT cord-017784-4r3fpmlb 110 44 appropriate appropriate JJ cord-017784-4r3fpmlb 110 45 regimen regimen NN cord-017784-4r3fpmlb 110 46 . . . cord-017784-4r3fpmlb 111 1 In in IN cord-017784-4r3fpmlb 111 2 patients patient NNS cord-017784-4r3fpmlb 111 3 with with IN cord-017784-4r3fpmlb 111 4 risk risk NN cord-017784-4r3fpmlb 111 5 factors factor NNS cord-017784-4r3fpmlb 111 6 of of IN cord-017784-4r3fpmlb 111 7 aspiration aspiration NN cord-017784-4r3fpmlb 111 8 , , , cord-017784-4r3fpmlb 111 9 an an DT cord-017784-4r3fpmlb 111 10 antibiotic antibiotic NN cord-017784-4r3fpmlb 111 11 should should MD cord-017784-4r3fpmlb 111 12 be be VB cord-017784-4r3fpmlb 111 13 used use VBN cord-017784-4r3fpmlb 111 14 which which WDT cord-017784-4r3fpmlb 111 15 should should MD cord-017784-4r3fpmlb 111 16 also also RB cord-017784-4r3fpmlb 111 17 cover cover VB cord-017784-4r3fpmlb 111 18 S. S. NNP cord-017784-4r3fpmlb 111 19 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 111 20 and and CC cord-017784-4r3fpmlb 111 21 be be VB cord-017784-4r3fpmlb 111 22 effective effective JJ cord-017784-4r3fpmlb 111 23 against against IN cord-017784-4r3fpmlb 111 24 anaerobes anaerobe NNS cord-017784-4r3fpmlb 111 25 and and CC cord-017784-4r3fpmlb 111 26 Enterobacteriaceae Enterobacteriaceae NNP cord-017784-4r3fpmlb 111 27 since since IN cord-017784-4r3fpmlb 111 28 these these DT cord-017784-4r3fpmlb 111 29 may may MD cord-017784-4r3fpmlb 111 30 be be VB cord-017784-4r3fpmlb 111 31 the the DT cord-017784-4r3fpmlb 111 32 causal causal JJ cord-017784-4r3fpmlb 111 33 microorganisms microorganism NNS cord-017784-4r3fpmlb 111 34 involved involve VBN cord-017784-4r3fpmlb 111 35 . . . cord-017784-4r3fpmlb 112 1 In in IN cord-017784-4r3fpmlb 112 2 most most JJS cord-017784-4r3fpmlb 112 3 guidelines guideline NNS cord-017784-4r3fpmlb 112 4 , , , cord-017784-4r3fpmlb 112 5 β β NN cord-017784-4r3fpmlb 112 6 - - HYPH cord-017784-4r3fpmlb 112 7 lactam lactam NNP cord-017784-4r3fpmlb 112 8 / / SYM cord-017784-4r3fpmlb 112 9 β β NN cord-017784-4r3fpmlb 112 10 - - HYPH cord-017784-4r3fpmlb 112 11 lactamase lactamase NNP cord-017784-4r3fpmlb 112 12 inhibitors inhibitor NNS cord-017784-4r3fpmlb 112 13 ( ( -LRB- cord-017784-4r3fpmlb 112 14 amoxicillin amoxicillin NNP cord-017784-4r3fpmlb 112 15 - - HYPH cord-017784-4r3fpmlb 112 16 clavulanate clavulanate NNP cord-017784-4r3fpmlb 112 17 , , , cord-017784-4r3fpmlb 112 18 ampicillin ampicillin NN cord-017784-4r3fpmlb 112 19 / / SYM cord-017784-4r3fpmlb 112 20 sulbactam sulbactam NNP cord-017784-4r3fpmlb 112 21 / / SYM cord-017784-4r3fpmlb 112 22 piperacillin piperacillin NNP cord-017784-4r3fpmlb 112 23 / / SYM cord-017784-4r3fpmlb 112 24 tazobactam tazobactam NNP cord-017784-4r3fpmlb 112 25 ) ) -RRB- cord-017784-4r3fpmlb 112 26 are be VBP cord-017784-4r3fpmlb 112 27 considered consider VBN cord-017784-4r3fpmlb 112 28 to to TO cord-017784-4r3fpmlb 112 29 be be VB cord-017784-4r3fpmlb 112 30 the the DT cord-017784-4r3fpmlb 112 31 antibiotics antibiotic NNS cord-017784-4r3fpmlb 112 32 of of IN cord-017784-4r3fpmlb 112 33 choice choice NN cord-017784-4r3fpmlb 112 34 . . . cord-017784-4r3fpmlb 113 1 Ceftriaxone Ceftriaxone NNP cord-017784-4r3fpmlb 113 2 plus plus CC cord-017784-4r3fpmlb 113 3 clindamycin clindamycin NN cord-017784-4r3fpmlb 113 4 or or CC cord-017784-4r3fpmlb 113 5 metronidazole metronidazole NN cord-017784-4r3fpmlb 113 6 and and CC cord-017784-4r3fpmlb 113 7 respiratory respiratory JJ cord-017784-4r3fpmlb 113 8 fluoroquinolone fluoroquinolone NN cord-017784-4r3fpmlb 113 9 are be VBP cord-017784-4r3fpmlb 113 10 the the DT cord-017784-4r3fpmlb 113 11 alternative alternative NN cord-017784-4r3fpmlb 113 12 . . . cord-017784-4r3fpmlb 114 1 For for IN cord-017784-4r3fpmlb 114 2 patients patient NNS cord-017784-4r3fpmlb 114 3 at at IN cord-017784-4r3fpmlb 114 4 the the DT cord-017784-4r3fpmlb 114 5 increasing increase VBG cord-017784-4r3fpmlb 114 6 rise rise NN cord-017784-4r3fpmlb 114 7 of of IN cord-017784-4r3fpmlb 114 8 resistances resistance NNS cord-017784-4r3fpmlb 114 9 of of IN cord-017784-4r3fpmlb 114 10 Enterobacteriaceae Enterobacteriaceae NNP cord-017784-4r3fpmlb 114 11 ertapenem ertapenem NN cord-017784-4r3fpmlb 114 12 this this DT cord-017784-4r3fpmlb 114 13 therapeutic therapeutic JJ cord-017784-4r3fpmlb 114 14 option option NN cord-017784-4r3fpmlb 114 15 is be VBZ cord-017784-4r3fpmlb 114 16 valid valid JJ cord-017784-4r3fpmlb 114 17 mainly mainly RB cord-017784-4r3fpmlb 114 18 for for IN cord-017784-4r3fpmlb 114 19 its -PRON- PRP$ cord-017784-4r3fpmlb 114 20 sensitivity sensitivity NN cord-017784-4r3fpmlb 114 21 versus versus IN cord-017784-4r3fpmlb 114 22 anaerobes anaerobe NNS cord-017784-4r3fpmlb 114 23 , , , cord-017784-4r3fpmlb 114 24 S. S. NNP cord-017784-4r3fpmlb 114 25 pneumoniae pneumoniae NN cord-017784-4r3fpmlb 114 26 , , , cord-017784-4r3fpmlb 114 27 and and CC cord-017784-4r3fpmlb 114 28 all all PDT cord-017784-4r3fpmlb 114 29 the the DT cord-017784-4r3fpmlb 114 30 Enterobacteriaceae Enterobacteriaceae NNP cord-017784-4r3fpmlb 114 31 , , , cord-017784-4r3fpmlb 114 32 including include VBG cord-017784-4r3fpmlb 114 33 extended extend VBN cord-017784-4r3fpmlb 114 34 - - HYPH cord-017784-4r3fpmlb 114 35 spectrum spectrum NN cord-017784-4r3fpmlb 114 36 β β NN cord-017784-4r3fpmlb 114 37 - - HYPH cord-017784-4r3fpmlb 114 38 Lactamase Lactamase NNP cord-017784-4r3fpmlb 114 39 - - HYPH cord-017784-4r3fpmlb 114 40 producing produce VBG cord-017784-4r3fpmlb 114 41 ( ( -LRB- cord-017784-4r3fpmlb 114 42 ESBL ESBL NNP cord-017784-4r3fpmlb 114 43 ) ) -RRB- cord-017784-4r3fpmlb 114 44 . . . cord-017784-4r3fpmlb 115 1 Antibiotic antibiotic JJ cord-017784-4r3fpmlb 115 2 agents agent NNS cord-017784-4r3fpmlb 115 3 with with IN cord-017784-4r3fpmlb 115 4 specific specific JJ cord-017784-4r3fpmlb 115 5 anaerobic anaerobic JJ cord-017784-4r3fpmlb 115 6 activity activity NN cord-017784-4r3fpmlb 115 7 ( ( -LRB- cord-017784-4r3fpmlb 115 8 metronidazole metronidazole NN cord-017784-4r3fpmlb 115 9 or or CC cord-017784-4r3fpmlb 115 10 clindamycin clindamycin NN cord-017784-4r3fpmlb 115 11 ) ) -RRB- cord-017784-4r3fpmlb 115 12 are be VBP cord-017784-4r3fpmlb 115 13 not not RB cord-017784-4r3fpmlb 115 14 routinely routinely RB cord-017784-4r3fpmlb 115 15 warranted warrant VBN cord-017784-4r3fpmlb 115 16 and and CC cord-017784-4r3fpmlb 115 17 may may MD cord-017784-4r3fpmlb 115 18 be be VB cord-017784-4r3fpmlb 115 19 indicated indicate VBN cord-017784-4r3fpmlb 115 20 only only RB cord-017784-4r3fpmlb 115 21 in in IN cord-017784-4r3fpmlb 115 22 patients patient NNS cord-017784-4r3fpmlb 115 23 with with IN cord-017784-4r3fpmlb 115 24 severe severe JJ cord-017784-4r3fpmlb 115 25 periodontal periodontal JJ cord-017784-4r3fpmlb 115 26 disease disease NN cord-017784-4r3fpmlb 115 27 , , , cord-017784-4r3fpmlb 115 28 putrid putrid JJ cord-017784-4r3fpmlb 115 29 sputum sputum NN cord-017784-4r3fpmlb 115 30 , , , cord-017784-4r3fpmlb 115 31 or or CC cord-017784-4r3fpmlb 115 32 evidence evidence NN cord-017784-4r3fpmlb 115 33 of of IN cord-017784-4r3fpmlb 115 34 necrotizing necrotize VBG cord-017784-4r3fpmlb 115 35 pneumonia pneumonia NN cord-017784-4r3fpmlb 115 36 or or CC cord-017784-4r3fpmlb 115 37 lung lung NN cord-017784-4r3fpmlb 115 38 abscess abscess NN cord-017784-4r3fpmlb 115 39 on on IN cord-017784-4r3fpmlb 115 40 radiographs radiograph NNS cord-017784-4r3fpmlb 115 41 of of IN cord-017784-4r3fpmlb 115 42 the the DT cord-017784-4r3fpmlb 115 43 chest chest NN cord-017784-4r3fpmlb 115 44 . . . cord-017784-4r3fpmlb 116 1 Antiviral antiviral JJ cord-017784-4r3fpmlb 116 2 treatment treatment NN cord-017784-4r3fpmlb 116 3 is be VBZ cord-017784-4r3fpmlb 116 4 recommended recommend VBN cord-017784-4r3fpmlb 116 5 as as RB cord-017784-4r3fpmlb 116 6 early early RB cord-017784-4r3fpmlb 116 7 as as IN cord-017784-4r3fpmlb 116 8 possible possible JJ cord-017784-4r3fpmlb 116 9 for for IN cord-017784-4r3fpmlb 116 10 any any DT cord-017784-4r3fpmlb 116 11 patient patient NN cord-017784-4r3fpmlb 116 12 with with IN cord-017784-4r3fpmlb 116 13 confirmed confirm VBN cord-017784-4r3fpmlb 116 14 or or CC cord-017784-4r3fpmlb 116 15 suspected suspect VBN cord-017784-4r3fpmlb 116 16 influenza influenza NN cord-017784-4r3fpmlb 116 17 pneumonia pneumonia NN cord-017784-4r3fpmlb 116 18 and and CC cord-017784-4r3fpmlb 116 19 should should MD cord-017784-4r3fpmlb 116 20 not not RB cord-017784-4r3fpmlb 116 21 be be VB cord-017784-4r3fpmlb 116 22 delayed delay VBN cord-017784-4r3fpmlb 116 23 by by IN cord-017784-4r3fpmlb 116 24 confirmatory confirmatory JJ cord-017784-4r3fpmlb 116 25 laboratory laboratory NN cord-017784-4r3fpmlb 116 26 testing testing NN cord-017784-4r3fpmlb 116 27 results result NNS cord-017784-4r3fpmlb 116 28 . . . cord-017784-4r3fpmlb 117 1 Neuraminidase Neuraminidase NNP cord-017784-4r3fpmlb 117 2 inhibitors inhibitor NNS cord-017784-4r3fpmlb 117 3 , , , cord-017784-4r3fpmlb 117 4 oseltamivir oseltamivir FW cord-017784-4r3fpmlb 117 5 and and CC cord-017784-4r3fpmlb 117 6 zanamivir zanamivir NNP cord-017784-4r3fpmlb 117 7 , , , cord-017784-4r3fpmlb 117 8 are be VBP cord-017784-4r3fpmlb 117 9 the the DT cord-017784-4r3fpmlb 117 10 agents agent NNS cord-017784-4r3fpmlb 117 11 of of IN cord-017784-4r3fpmlb 117 12 choice choice NN cord-017784-4r3fpmlb 117 13 . . . cord-017784-4r3fpmlb 118 1 The the DT cord-017784-4r3fpmlb 118 2 usual usual JJ cord-017784-4r3fpmlb 118 3 dosing dosing NN cord-017784-4r3fpmlb 118 4 of of IN cord-017784-4r3fpmlb 118 5 oseltamivir oseltamivir NN cord-017784-4r3fpmlb 118 6 for for IN cord-017784-4r3fpmlb 118 7 the the DT cord-017784-4r3fpmlb 118 8 treatment treatment NN cord-017784-4r3fpmlb 118 9 of of IN cord-017784-4r3fpmlb 118 10 influenza influenza NN cord-017784-4r3fpmlb 118 11 is be VBZ cord-017784-4r3fpmlb 118 12 75 75 CD cord-017784-4r3fpmlb 118 13 mg mg PRP cord-017784-4r3fpmlb 118 14 orally orally RB cord-017784-4r3fpmlb 118 15 twice twice RB cord-017784-4r3fpmlb 118 16 daily daily RB cord-017784-4r3fpmlb 118 17 and and CC cord-017784-4r3fpmlb 118 18 of of IN cord-017784-4r3fpmlb 118 19 zanamivir zanamivir NNP cord-017784-4r3fpmlb 119 1 is be VBZ cord-017784-4r3fpmlb 119 2 10 10 CD cord-017784-4r3fpmlb 119 3 mg mg NN cord-017784-4r3fpmlb 119 4 ( ( -LRB- cord-017784-4r3fpmlb 119 5 2 2 CD cord-017784-4r3fpmlb 119 6 inhalations inhalations NNPS cord-017784-4r3fpmlb 119 7 ) ) -RRB- cord-017784-4r3fpmlb 119 8 twice twice RB cord-017784-4r3fpmlb 119 9 daily daily RB cord-017784-4r3fpmlb 119 10 . . . cord-017784-4r3fpmlb 120 1 The the DT cord-017784-4r3fpmlb 120 2 recommended recommend VBN cord-017784-4r3fpmlb 120 3 duration duration NN cord-017784-4r3fpmlb 120 4 for for IN cord-017784-4r3fpmlb 120 5 antiviral antiviral JJ cord-017784-4r3fpmlb 120 6 treatment treatment NN cord-017784-4r3fpmlb 120 7 is be VBZ cord-017784-4r3fpmlb 120 8 5 5 CD cord-017784-4r3fpmlb 120 9 days day NNS cord-017784-4r3fpmlb 120 10 . . . cord-017784-4r3fpmlb 121 1 The the DT cord-017784-4r3fpmlb 121 2 optimal optimal JJ cord-017784-4r3fpmlb 121 3 duration duration NN cord-017784-4r3fpmlb 121 4 of of IN cord-017784-4r3fpmlb 121 5 antibiotic antibiotic JJ cord-017784-4r3fpmlb 121 6 therapy therapy NN cord-017784-4r3fpmlb 121 7 is be VBZ cord-017784-4r3fpmlb 121 8 not not RB cord-017784-4r3fpmlb 121 9 yet yet RB cord-017784-4r3fpmlb 121 10 known know VBN cord-017784-4r3fpmlb 121 11 . . . cord-017784-4r3fpmlb 122 1 BTS BTS NNP cord-017784-4r3fpmlb 122 2 guidelines guideline NNS cord-017784-4r3fpmlb 122 3 [ [ -LRB- cord-017784-4r3fpmlb 122 4 26 26 CD cord-017784-4r3fpmlb 122 5 ] ] -RRB- cord-017784-4r3fpmlb 122 6 propose propose VB cord-017784-4r3fpmlb 122 7 7 7 CD cord-017784-4r3fpmlb 122 8 - - SYM cord-017784-4r3fpmlb 122 9 10 10 CD cord-017784-4r3fpmlb 122 10 days day NNS cord-017784-4r3fpmlb 122 11 treatment treatment NN cord-017784-4r3fpmlb 122 12 for for IN cord-017784-4r3fpmlb 122 13 most most JJS cord-017784-4r3fpmlb 122 14 patients patient NNS cord-017784-4r3fpmlb 122 15 with with IN cord-017784-4r3fpmlb 122 16 severe severe JJ cord-017784-4r3fpmlb 122 17 CAP cap NN cord-017784-4r3fpmlb 122 18 , , , cord-017784-4r3fpmlb 122 19 whereas whereas IN cord-017784-4r3fpmlb 122 20 European european JJ cord-017784-4r3fpmlb 122 21 guidelines guideline NNS cord-017784-4r3fpmlb 122 22 [ [ -LRB- cord-017784-4r3fpmlb 122 23 27 27 CD cord-017784-4r3fpmlb 122 24 ] ] -RRB- cord-017784-4r3fpmlb 122 25 suggest suggest VBP cord-017784-4r3fpmlb 122 26 that that IN cord-017784-4r3fpmlb 122 27 the the DT cord-017784-4r3fpmlb 122 28 duration duration NN cord-017784-4r3fpmlb 122 29 of of IN cord-017784-4r3fpmlb 122 30 treatment treatment NN cord-017784-4r3fpmlb 122 31 should should MD cord-017784-4r3fpmlb 122 32 generally generally RB cord-017784-4r3fpmlb 122 33 not not RB cord-017784-4r3fpmlb 122 34 exceed exceed VB cord-017784-4r3fpmlb 122 35 8 8 CD cord-017784-4r3fpmlb 122 36 days day NNS cord-017784-4r3fpmlb 122 37 in in IN cord-017784-4r3fpmlb 122 38 a a DT cord-017784-4r3fpmlb 122 39 patient patient NN cord-017784-4r3fpmlb 122 40 who who WP cord-017784-4r3fpmlb 122 41 responds respond VBZ cord-017784-4r3fpmlb 122 42 to to IN cord-017784-4r3fpmlb 122 43 initial initial JJ cord-017784-4r3fpmlb 122 44 therapy therapy NN cord-017784-4r3fpmlb 122 45 . . . cord-017784-4r3fpmlb 123 1 The the DT cord-017784-4r3fpmlb 123 2 use use NN cord-017784-4r3fpmlb 123 3 of of IN cord-017784-4r3fpmlb 123 4 biomarkers biomarker NNS cord-017784-4r3fpmlb 123 5 such such JJ cord-017784-4r3fpmlb 123 6 as as IN cord-017784-4r3fpmlb 123 7 procalcitonin procalcitonin NNS cord-017784-4r3fpmlb 123 8 or or CC cord-017784-4r3fpmlb 123 9 the the DT cord-017784-4r3fpmlb 123 10 C C NNP cord-017784-4r3fpmlb 123 11 - - HYPH cord-017784-4r3fpmlb 123 12 reactive reactive JJ cord-017784-4r3fpmlb 123 13 protein protein NN cord-017784-4r3fpmlb 123 14 may may MD cord-017784-4r3fpmlb 123 15 be be VB cord-017784-4r3fpmlb 123 16 useful useful JJ cord-017784-4r3fpmlb 123 17 to to TO cord-017784-4r3fpmlb 123 18 shorten shorten VB cord-017784-4r3fpmlb 123 19 the the DT cord-017784-4r3fpmlb 123 20 duration duration NN cord-017784-4r3fpmlb 123 21 of of IN cord-017784-4r3fpmlb 123 22 antibiotic antibiotic JJ cord-017784-4r3fpmlb 123 23 treatment treatment NN cord-017784-4r3fpmlb 123 24 [ [ -LRB- cord-017784-4r3fpmlb 123 25 28 28 CD cord-017784-4r3fpmlb 123 26 ] ] -RRB- cord-017784-4r3fpmlb 123 27 . . . cord-017784-4r3fpmlb 124 1 The the DT cord-017784-4r3fpmlb 124 2 duration duration NN cord-017784-4r3fpmlb 124 3 of of IN cord-017784-4r3fpmlb 124 4 antibiotic antibiotic JJ cord-017784-4r3fpmlb 124 5 treatment treatment NN cord-017784-4r3fpmlb 124 6 may may MD cord-017784-4r3fpmlb 124 7 be be VB cord-017784-4r3fpmlb 124 8 prolonged prolong VBN cord-017784-4r3fpmlb 124 9 in in IN cord-017784-4r3fpmlb 124 10 patients patient NNS cord-017784-4r3fpmlb 124 11 receiving receive VBG cord-017784-4r3fpmlb 124 12 initial initial JJ cord-017784-4r3fpmlb 124 13 inadequate inadequate JJ cord-017784-4r3fpmlb 124 14 antibiotic antibiotic JJ cord-017784-4r3fpmlb 124 15 therapy therapy NN cord-017784-4r3fpmlb 124 16 , , , cord-017784-4r3fpmlb 124 17 patients patient NNS cord-017784-4r3fpmlb 124 18 with with IN cord-017784-4r3fpmlb 124 19 extrapulmonary extrapulmonary JJ cord-017784-4r3fpmlb 124 20 infection infection NN cord-017784-4r3fpmlb 124 21 ( ( -LRB- cord-017784-4r3fpmlb 124 22 e.g. e.g. RB cord-017784-4r3fpmlb 124 23 , , , cord-017784-4r3fpmlb 124 24 endocarditis endocarditis NN cord-017784-4r3fpmlb 124 25 , , , cord-017784-4r3fpmlb 124 26 meningitis meningitis NN cord-017784-4r3fpmlb 124 27 ) ) -RRB- cord-017784-4r3fpmlb 124 28 , , , cord-017784-4r3fpmlb 124 29 patients patient NNS cord-017784-4r3fpmlb 124 30 infected infect VBN cord-017784-4r3fpmlb 124 31 with with IN cord-017784-4r3fpmlb 124 32 multi multi JJ cord-017784-4r3fpmlb 124 33 - - JJ cord-017784-4r3fpmlb 124 34 drugresistant drugresistant JJ cord-017784-4r3fpmlb 124 35 organism organism NN cord-017784-4r3fpmlb 124 36 ( ( -LRB- cord-017784-4r3fpmlb 124 37 e.g. e.g. RB cord-017784-4r3fpmlb 124 38 , , , cord-017784-4r3fpmlb 124 39 S. S. NNP cord-017784-4r3fpmlb 124 40 aureus aureus NN cord-017784-4r3fpmlb 124 41 ) ) -RRB- cord-017784-4r3fpmlb 124 42 and and CC cord-017784-4r3fpmlb 124 43 patients patient NNS cord-017784-4r3fpmlb 124 44 with with IN cord-017784-4r3fpmlb 124 45 necrotizing necrotize VBG cord-017784-4r3fpmlb 124 46 pneumonia pneumonia NN cord-017784-4r3fpmlb 124 47 . . . cord-017784-4r3fpmlb 125 1 Regarding regard VBG cord-017784-4r3fpmlb 125 2 the the DT cord-017784-4r3fpmlb 125 3 dosing dosing NN cord-017784-4r3fpmlb 125 4 ( ( -LRB- cord-017784-4r3fpmlb 125 5 Table table NN cord-017784-4r3fpmlb 125 6 5 5 CD cord-017784-4r3fpmlb 125 7 . . . cord-017784-4r3fpmlb 125 8 3 3 LS cord-017784-4r3fpmlb 125 9 ) ) -RRB- cord-017784-4r3fpmlb 125 10 , , , cord-017784-4r3fpmlb 125 11 there there EX cord-017784-4r3fpmlb 125 12 are be VBP cord-017784-4r3fpmlb 125 13 many many JJ cord-017784-4r3fpmlb 125 14 considerations consideration NNS cord-017784-4r3fpmlb 125 15 to to TO cord-017784-4r3fpmlb 125 16 be be VB cord-017784-4r3fpmlb 125 17 made make VBN cord-017784-4r3fpmlb 125 18 when when WRB cord-017784-4r3fpmlb 125 19 caring care VBG cord-017784-4r3fpmlb 125 20 for for IN cord-017784-4r3fpmlb 125 21 elderly elderly JJ cord-017784-4r3fpmlb 125 22 patients patient NNS cord-017784-4r3fpmlb 125 23 : : : cord-017784-4r3fpmlb 125 24 multiple multiple JJ cord-017784-4r3fpmlb 125 25 comorbidities comorbiditie NNS cord-017784-4r3fpmlb 125 26 , , , cord-017784-4r3fpmlb 125 27 polypharmacy polypharmacy FW cord-017784-4r3fpmlb 125 28 potentially potentially RB cord-017784-4r3fpmlb 125 29 resulting result VBG cord-017784-4r3fpmlb 125 30 in in IN cord-017784-4r3fpmlb 125 31 drug drug NN cord-017784-4r3fpmlb 125 32 interactions interaction NNS cord-017784-4r3fpmlb 125 33 , , , cord-017784-4r3fpmlb 125 34 pharmacokinetic pharmacokinetic JJ cord-017784-4r3fpmlb 125 35 and and CC cord-017784-4r3fpmlb 125 36 pharmacodynamic pharmacodynamic JJ cord-017784-4r3fpmlb 125 37 changes change NNS cord-017784-4r3fpmlb 125 38 that that WDT cord-017784-4r3fpmlb 125 39 can can MD cord-017784-4r3fpmlb 125 40 result result VB cord-017784-4r3fpmlb 125 41 in in IN cord-017784-4r3fpmlb 125 42 altered altered JJ cord-017784-4r3fpmlb 125 43 drug drug NN cord-017784-4r3fpmlb 125 44 metabolism metabolism NN cord-017784-4r3fpmlb 125 45 and and CC cord-017784-4r3fpmlb 125 46 subsequent subsequent JJ cord-017784-4r3fpmlb 125 47 toxic toxic JJ cord-017784-4r3fpmlb 125 48 effects effect NNS cord-017784-4r3fpmlb 125 49 of of IN cord-017784-4r3fpmlb 125 50 drug drug NN cord-017784-4r3fpmlb 125 51 accumulation accumulation NN cord-017784-4r3fpmlb 125 52 [ [ -LRB- cord-017784-4r3fpmlb 125 53 29 29 CD cord-017784-4r3fpmlb 125 54 ] ] -RRB- cord-017784-4r3fpmlb 125 55 . . . cord-017784-4r3fpmlb 126 1 Despite despite IN cord-017784-4r3fpmlb 126 2 the the DT cord-017784-4r3fpmlb 126 3 complexity complexity NN cord-017784-4r3fpmlb 126 4 of of IN cord-017784-4r3fpmlb 126 5 all all DT cord-017784-4r3fpmlb 126 6 of of IN cord-017784-4r3fpmlb 126 7 these these DT cord-017784-4r3fpmlb 126 8 changes change NNS cord-017784-4r3fpmlb 126 9 , , , cord-017784-4r3fpmlb 126 10 however however RB cord-017784-4r3fpmlb 126 11 , , , cord-017784-4r3fpmlb 126 12 the the DT cord-017784-4r3fpmlb 126 13 singular singular JJ cord-017784-4r3fpmlb 126 14 impairment impairment NN cord-017784-4r3fpmlb 126 15 that that WDT cord-017784-4r3fpmlb 126 16 most most RBS cord-017784-4r3fpmlb 126 17 significantly significantly RB cord-017784-4r3fpmlb 126 18 influences influence VBZ cord-017784-4r3fpmlb 126 19 the the DT cord-017784-4r3fpmlb 126 20 medical medical JJ cord-017784-4r3fpmlb 126 21 management management NN cord-017784-4r3fpmlb 126 22 of of IN cord-017784-4r3fpmlb 126 23 infection infection NN cord-017784-4r3fpmlb 126 24 in in IN cord-017784-4r3fpmlb 126 25 older old JJR cord-017784-4r3fpmlb 126 26 patients patient NNS cord-017784-4r3fpmlb 126 27 is be VBZ cord-017784-4r3fpmlb 126 28 the the DT cord-017784-4r3fpmlb 126 29 decline decline NN cord-017784-4r3fpmlb 126 30 in in IN cord-017784-4r3fpmlb 126 31 renal renal JJ cord-017784-4r3fpmlb 126 32 function function NN cord-017784-4r3fpmlb 126 33 commonly commonly RB cord-017784-4r3fpmlb 126 34 observed observe VBD cord-017784-4r3fpmlb 126 35 in in IN cord-017784-4r3fpmlb 126 36 this this DT cord-017784-4r3fpmlb 126 37 group group NN cord-017784-4r3fpmlb 126 38 . . . cord-017784-4r3fpmlb 127 1 In in IN cord-017784-4r3fpmlb 127 2 patients patient NNS cord-017784-4r3fpmlb 127 3 with with IN cord-017784-4r3fpmlb 127 4 impaired impaired JJ cord-017784-4r3fpmlb 127 5 renal renal JJ cord-017784-4r3fpmlb 127 6 function function NN cord-017784-4r3fpmlb 127 7 , , , cord-017784-4r3fpmlb 127 8 antibiotics antibiotic NNS cord-017784-4r3fpmlb 127 9 should should MD cord-017784-4r3fpmlb 127 10 always always RB cord-017784-4r3fpmlb 127 11 be be VB cord-017784-4r3fpmlb 127 12 started start VBN cord-017784-4r3fpmlb 127 13 at at IN cord-017784-4r3fpmlb 127 14 full full JJ cord-017784-4r3fpmlb 127 15 initial initial JJ cord-017784-4r3fpmlb 127 16 doses dose NNS cord-017784-4r3fpmlb 127 17 and and CC cord-017784-4r3fpmlb 127 18 then then RB cord-017784-4r3fpmlb 127 19 adjusted adjust VBN cord-017784-4r3fpmlb 127 20 based base VBN cord-017784-4r3fpmlb 127 21 on on IN cord-017784-4r3fpmlb 127 22 renal renal JJ cord-017784-4r3fpmlb 127 23 function function NN cord-017784-4r3fpmlb 127 24 . . . cord-017784-4r3fpmlb 128 1 Lower low JJR cord-017784-4r3fpmlb 128 2 respiratory respiratory JJ cord-017784-4r3fpmlb 128 3 tract tract NN cord-017784-4r3fpmlb 128 4 infections infection NNS cord-017784-4r3fpmlb 128 5 , , , cord-017784-4r3fpmlb 128 6 including include VBG cord-017784-4r3fpmlb 128 7 pneumonia pneumonia NN cord-017784-4r3fpmlb 128 8 and and CC cord-017784-4r3fpmlb 128 9 exacerbation exacerbation NN cord-017784-4r3fpmlb 128 10 of of IN cord-017784-4r3fpmlb 128 11 chronic chronic JJ cord-017784-4r3fpmlb 128 12 obstructive obstructive JJ cord-017784-4r3fpmlb 128 13 pulmonary pulmonary JJ cord-017784-4r3fpmlb 128 14 disease disease NN cord-017784-4r3fpmlb 128 15 , , , cord-017784-4r3fpmlb 128 16 are be VBP cord-017784-4r3fpmlb 128 17 among among IN cord-017784-4r3fpmlb 128 18 the the DT cord-017784-4r3fpmlb 128 19 most most RBS cord-017784-4r3fpmlb 128 20 common common JJ cord-017784-4r3fpmlb 128 21 causes cause NNS cord-017784-4r3fpmlb 128 22 of of IN cord-017784-4r3fpmlb 128 23 ARF arf NN cord-017784-4r3fpmlb 128 24 in in IN cord-017784-4r3fpmlb 128 25 elderly elderly JJ cord-017784-4r3fpmlb 128 26 people people NNS cord-017784-4r3fpmlb 128 27 and and CC cord-017784-4r3fpmlb 128 28 the the DT cord-017784-4r3fpmlb 128 29 most most RBS cord-017784-4r3fpmlb 128 30 important important JJ cord-017784-4r3fpmlb 128 31 cause cause NN cord-017784-4r3fpmlb 128 32 of of IN cord-017784-4r3fpmlb 128 33 hospitalization hospitalization NN cord-017784-4r3fpmlb 128 34 . . . cord-017784-4r3fpmlb 129 1 Moreover moreover RB cord-017784-4r3fpmlb 129 2 pulmonary pulmonary JJ cord-017784-4r3fpmlb 129 3 infection infection NN cord-017784-4r3fpmlb 129 4 is be VBZ cord-017784-4r3fpmlb 129 5 also also RB cord-017784-4r3fpmlb 129 6 the the DT cord-017784-4r3fpmlb 129 7 most most RBS cord-017784-4r3fpmlb 129 8 frequent frequent JJ cord-017784-4r3fpmlb 129 9 single single JJ cord-017784-4r3fpmlb 129 10 cause cause NN cord-017784-4r3fpmlb 129 11 of of IN cord-017784-4r3fpmlb 129 12 ARDS ARDS NNP cord-017784-4r3fpmlb 129 13 . . . cord-017784-4r3fpmlb 130 1 In in IN cord-017784-4r3fpmlb 130 2 the the DT cord-017784-4r3fpmlb 130 3 management management NN cord-017784-4r3fpmlb 130 4 of of IN cord-017784-4r3fpmlb 130 5 respiratory respiratory JJ cord-017784-4r3fpmlb 130 6 failure failure NN cord-017784-4r3fpmlb 130 7 , , , cord-017784-4r3fpmlb 130 8 it -PRON- PRP cord-017784-4r3fpmlb 130 9 is be VBZ cord-017784-4r3fpmlb 130 10 mandatory mandatory JJ cord-017784-4r3fpmlb 130 11 reversing reversing NN cord-017784-4r3fpmlb 130 12 and/or and/or CC cord-017784-4r3fpmlb 130 13 preventing prevent VBG cord-017784-4r3fpmlb 130 14 tissue tissue NN cord-017784-4r3fpmlb 130 15 hypoxia hypoxia NN cord-017784-4r3fpmlb 130 16 through through IN cord-017784-4r3fpmlb 130 17 conventional conventional JJ cord-017784-4r3fpmlb 130 18 oxygen oxygen NN cord-017784-4r3fpmlb 130 19 therapy therapy NN cord-017784-4r3fpmlb 130 20 or or CC cord-017784-4r3fpmlb 130 21 invasive invasive JJ cord-017784-4r3fpmlb 130 22 or or CC cord-017784-4r3fpmlb 130 23 non non JJ cord-017784-4r3fpmlb 130 24 - - JJ cord-017784-4r3fpmlb 130 25 invasive invasive JJ cord-017784-4r3fpmlb 130 26 mechanical mechanical JJ cord-017784-4r3fpmlb 130 27 ventilation ventilation NN cord-017784-4r3fpmlb 130 28 . . . cord-017784-4r3fpmlb 131 1 Besides besides RB cord-017784-4r3fpmlb 131 2 , , , cord-017784-4r3fpmlb 131 3 early early JJ cord-017784-4r3fpmlb 131 4 administration administration NN cord-017784-4r3fpmlb 131 5 of of IN cord-017784-4r3fpmlb 131 6 appropriate appropriate JJ cord-017784-4r3fpmlb 131 7 antimicrobials antimicrobial NNS cord-017784-4r3fpmlb 131 8 has have VBZ cord-017784-4r3fpmlb 131 9 been be VBN cord-017784-4r3fpmlb 131 10 postulated postulate VBN cord-017784-4r3fpmlb 131 11 as as IN cord-017784-4r3fpmlb 131 12 a a DT cord-017784-4r3fpmlb 131 13 key key JJ cord-017784-4r3fpmlb 131 14 strategy strategy NN cord-017784-4r3fpmlb 131 15 in in IN cord-017784-4r3fpmlb 131 16 the the DT cord-017784-4r3fpmlb 131 17 survival survival NN cord-017784-4r3fpmlb 131 18 of of IN cord-017784-4r3fpmlb 131 19 patients patient NNS cord-017784-4r3fpmlb 131 20 with with IN cord-017784-4r3fpmlb 131 21 very very RB cord-017784-4r3fpmlb 131 22 severe severe JJ cord-017784-4r3fpmlb 131 23 infections infection NNS cord-017784-4r3fpmlb 131 24 requiring require VBG cord-017784-4r3fpmlb 131 25 intensive intensive JJ cord-017784-4r3fpmlb 131 26 care care NN cord-017784-4r3fpmlb 131 27 unit unit NN cord-017784-4r3fpmlb 131 28 admission admission NN cord-017784-4r3fpmlb 131 29 taking take VBG cord-017784-4r3fpmlb 131 30 into into IN cord-017784-4r3fpmlb 131 31 account account NN cord-017784-4r3fpmlb 131 32 the the DT cord-017784-4r3fpmlb 131 33 most most JJS cord-017784-4r3fpmlb 131 34 risk risk NN cord-017784-4r3fpmlb 131 35 of of IN cord-017784-4r3fpmlb 131 36 adverse adverse JJ cord-017784-4r3fpmlb 131 37 events event NNS cord-017784-4r3fpmlb 131 38 of of IN cord-017784-4r3fpmlb 131 39 an an DT cord-017784-4r3fpmlb 131 40 antimicrobial antimicrobial NN cord-017784-4r3fpmlb 131 41 in in IN cord-017784-4r3fpmlb 131 42 a a DT cord-017784-4r3fpmlb 131 43 frail frail JJ cord-017784-4r3fpmlb 131 44 elderly elderly JJ cord-017784-4r3fpmlb 131 45 patient patient NN cord-017784-4r3fpmlb 131 46 . . . cord-017784-4r3fpmlb 132 1 1 1 LS cord-017784-4r3fpmlb 132 2 . . . cord-017784-4r3fpmlb 133 1 Acute acute JJ cord-017784-4r3fpmlb 133 2 respiratory respiratory JJ cord-017784-4r3fpmlb 133 3 failure failure NN cord-017784-4r3fpmlb 133 4 is be VBZ cord-017784-4r3fpmlb 133 5 a a DT cord-017784-4r3fpmlb 133 6 frequent frequent JJ cord-017784-4r3fpmlb 133 7 complication complication NN cord-017784-4r3fpmlb 133 8 in in IN cord-017784-4r3fpmlb 133 9 elderly elderly JJ cord-017784-4r3fpmlb 133 10 patients patient NNS cord-017784-4r3fpmlb 133 11 . . . cord-017784-4r3fpmlb 134 1 2 2 LS cord-017784-4r3fpmlb 134 2 . . . cord-017784-4r3fpmlb 135 1 Infections infection NNS cord-017784-4r3fpmlb 135 2 ( ( -LRB- cord-017784-4r3fpmlb 135 3 CAP cap NN cord-017784-4r3fpmlb 135 4 and and CC cord-017784-4r3fpmlb 135 5 AECOPD AECOPD NNP cord-017784-4r3fpmlb 135 6 ) ) -RRB- cord-017784-4r3fpmlb 135 7 are be VBP cord-017784-4r3fpmlb 135 8 among among IN cord-017784-4r3fpmlb 135 9 the the DT cord-017784-4r3fpmlb 135 10 most most RBS cord-017784-4r3fpmlb 135 11 frequent frequent JJ cord-017784-4r3fpmlb 135 12 triggering trigger VBG cord-017784-4r3fpmlb 135 13 causes cause NNS cord-017784-4r3fpmlb 135 14 of of IN cord-017784-4r3fpmlb 135 15 ARF arf NN cord-017784-4r3fpmlb 135 16 in in IN cord-017784-4r3fpmlb 135 17 advanced advanced JJ cord-017784-4r3fpmlb 135 18 aged aged JJ cord-017784-4r3fpmlb 135 19 patients patient NNS cord-017784-4r3fpmlb 135 20 . . . cord-017784-4r3fpmlb 136 1 3 3 LS cord-017784-4r3fpmlb 136 2 . . . cord-017784-4r3fpmlb 137 1 Antimicrobials antimicrobial NNS cord-017784-4r3fpmlb 137 2 are be VBP cord-017784-4r3fpmlb 137 3 the the DT cord-017784-4r3fpmlb 137 4 cornerstone cornerstone NN cord-017784-4r3fpmlb 137 5 of of IN cord-017784-4r3fpmlb 137 6 therapy therapy NN cord-017784-4r3fpmlb 137 7 for for IN cord-017784-4r3fpmlb 137 8 CAP CAP NNP cord-017784-4r3fpmlb 137 9 and and CC cord-017784-4r3fpmlb 137 10 in in IN cord-017784-4r3fpmlb 137 11 COPD COPD NNP cord-017784-4r3fpmlb 137 12 exacerbations exacerbation NNS cord-017784-4r3fpmlb 137 13 when when WRB cord-017784-4r3fpmlb 137 14 patients patient NNS cord-017784-4r3fpmlb 137 15 have have VBP cord-017784-4r3fpmlb 137 16 clinical clinical JJ cord-017784-4r3fpmlb 137 17 signs sign NNS cord-017784-4r3fpmlb 137 18 of of IN cord-017784-4r3fpmlb 137 19 a a DT cord-017784-4r3fpmlb 137 20 bacterial bacterial JJ cord-017784-4r3fpmlb 137 21 infection infection NN cord-017784-4r3fpmlb 137 22 . . . cord-017784-4r3fpmlb 138 1 4 4 LS cord-017784-4r3fpmlb 138 2 . . . cord-017784-4r3fpmlb 139 1 Antibiotic antibiotic JJ cord-017784-4r3fpmlb 139 2 duration duration NN cord-017784-4r3fpmlb 139 3 should should MD cord-017784-4r3fpmlb 139 4 be be VB cord-017784-4r3fpmlb 139 5 as as RB cord-017784-4r3fpmlb 139 6 shorter short JJR cord-017784-4r3fpmlb 139 7 as as IN cord-017784-4r3fpmlb 139 8 possible possible JJ cord-017784-4r3fpmlb 139 9 , , , cord-017784-4r3fpmlb 139 10 based base VBN cord-017784-4r3fpmlb 139 11 on on IN cord-017784-4r3fpmlb 139 12 the the DT cord-017784-4r3fpmlb 139 13 pathogen pathogen NN cord-017784-4r3fpmlb 139 14 , , , cord-017784-4r3fpmlb 139 15 clinical clinical JJ cord-017784-4r3fpmlb 139 16 response response NN cord-017784-4r3fpmlb 139 17 , , , cord-017784-4r3fpmlb 139 18 and and CC cord-017784-4r3fpmlb 139 19 presence presence NN cord-017784-4r3fpmlb 139 20 of of IN cord-017784-4r3fpmlb 139 21 complications complication NNS cord-017784-4r3fpmlb 139 22 . . . cord-017784-4r3fpmlb 140 1 5 5 LS cord-017784-4r3fpmlb 140 2 . . . cord-017784-4r3fpmlb 141 1 A a DT cord-017784-4r3fpmlb 141 2 judicious judicious JJ cord-017784-4r3fpmlb 141 3 use use NN cord-017784-4r3fpmlb 141 4 of of IN cord-017784-4r3fpmlb 141 5 antibiotic antibiotic JJ cord-017784-4r3fpmlb 141 6 therapy therapy NN cord-017784-4r3fpmlb 141 7 in in IN cord-017784-4r3fpmlb 141 8 the the DT cord-017784-4r3fpmlb 141 9 respiratory respiratory JJ cord-017784-4r3fpmlb 141 10 tract tract NN cord-017784-4r3fpmlb 141 11 infections infection NNS cord-017784-4r3fpmlb 141 12 is be VBZ cord-017784-4r3fpmlb 141 13 critical critical JJ cord-017784-4r3fpmlb 141 14 in in IN cord-017784-4r3fpmlb 141 15 the the DT cord-017784-4r3fpmlb 141 16 era era NN cord-017784-4r3fpmlb 141 17 of of IN cord-017784-4r3fpmlb 141 18 antibiotic antibiotic JJ cord-017784-4r3fpmlb 141 19 resistance resistance NN cord-017784-4r3fpmlb 141 20 . . . cord-017784-4r3fpmlb 142 1 The the DT cord-017784-4r3fpmlb 142 2 impact impact NN cord-017784-4r3fpmlb 142 3 of of IN cord-017784-4r3fpmlb 142 4 immunosenescence immunosenescence NN cord-017784-4r3fpmlb 142 5 on on IN cord-017784-4r3fpmlb 142 6 pulmonary pulmonary JJ cord-017784-4r3fpmlb 142 7 disease disease NN cord-017784-4r3fpmlb 142 8 Acute acute JJ cord-017784-4r3fpmlb 142 9 respiratory respiratory JJ cord-017784-4r3fpmlb 142 10 failure failure NN cord-017784-4r3fpmlb 142 11 in in IN cord-017784-4r3fpmlb 142 12 the the DT cord-017784-4r3fpmlb 142 13 elderly elderly JJ cord-017784-4r3fpmlb 142 14 : : : cord-017784-4r3fpmlb 142 15 etiology etiology NN cord-017784-4r3fpmlb 142 16 , , , cord-017784-4r3fpmlb 142 17 emergency emergency NN cord-017784-4r3fpmlb 142 18 diagnosis diagnosis NN cord-017784-4r3fpmlb 142 19 and and CC cord-017784-4r3fpmlb 142 20 prognosis prognosis NN cord-017784-4r3fpmlb 142 21 Respiratory respiratory JJ cord-017784-4r3fpmlb 142 22 failure failure NN cord-017784-4r3fpmlb 143 1 Acute acute JJ cord-017784-4r3fpmlb 143 2 respiratory respiratory JJ cord-017784-4r3fpmlb 143 3 failure failure NN cord-017784-4r3fpmlb 143 4 in in IN cord-017784-4r3fpmlb 143 5 the the DT cord-017784-4r3fpmlb 143 6 elderly elderly JJ cord-017784-4r3fpmlb 143 7 : : : cord-017784-4r3fpmlb 144 1 diagnosis diagnosis NN cord-017784-4r3fpmlb 144 2 and and CC cord-017784-4r3fpmlb 144 3 prognosis prognosis NN cord-017784-4r3fpmlb 144 4 acute acute JJ cord-017784-4r3fpmlb 144 5 respiratory respiratory JJ cord-017784-4r3fpmlb 144 6 distress distress NN cord-017784-4r3fpmlb 144 7 syndrome syndrome NN cord-017784-4r3fpmlb 144 8 , , , cord-017784-4r3fpmlb 144 9 and and CC cord-017784-4r3fpmlb 144 10 early early JJ cord-017784-4r3fpmlb 144 11 immune immune JJ cord-017784-4r3fpmlb 144 12 - - HYPH cord-017784-4r3fpmlb 144 13 modulator modulator NN cord-017784-4r3fpmlb 144 14 therapy therapy NN cord-017784-4r3fpmlb 145 1 The the DT cord-017784-4r3fpmlb 145 2 acute acute JJ cord-017784-4r3fpmlb 145 3 respiratory respiratory JJ cord-017784-4r3fpmlb 145 4 distress distress NN cord-017784-4r3fpmlb 145 5 syndrome syndrome NN cord-017784-4r3fpmlb 145 6 Acute acute JJ cord-017784-4r3fpmlb 145 7 respiratory respiratory JJ cord-017784-4r3fpmlb 145 8 distress distress NN cord-017784-4r3fpmlb 145 9 syndrome syndrome NN cord-017784-4r3fpmlb 145 10 Acute acute JJ cord-017784-4r3fpmlb 145 11 respiratory respiratory JJ cord-017784-4r3fpmlb 145 12 distress distress NN cord-017784-4r3fpmlb 145 13 syndrome syndrome NN cord-017784-4r3fpmlb 145 14 : : : cord-017784-4r3fpmlb 145 15 the the DT cord-017784-4r3fpmlb 145 16 Berlin Berlin NNP cord-017784-4r3fpmlb 145 17 definition definition NN cord-017784-4r3fpmlb 145 18 Antibiotic antibiotic JJ cord-017784-4r3fpmlb 145 19 therapy therapy NN cord-017784-4r3fpmlb 145 20 and and CC cord-017784-4r3fpmlb 145 21 treatment treatment NN cord-017784-4r3fpmlb 145 22 failure failure NN cord-017784-4r3fpmlb 145 23 in in IN cord-017784-4r3fpmlb 145 24 patients patient NNS cord-017784-4r3fpmlb 145 25 hospitalized hospitalize VBN cord-017784-4r3fpmlb 145 26 for for IN cord-017784-4r3fpmlb 145 27 acute acute JJ cord-017784-4r3fpmlb 145 28 exacerbations exacerbation NNS cord-017784-4r3fpmlb 145 29 of of IN cord-017784-4r3fpmlb 145 30 chronic chronic JJ cord-017784-4r3fpmlb 145 31 obstructive obstructive JJ cord-017784-4r3fpmlb 145 32 pulmonary pulmonary JJ cord-017784-4r3fpmlb 145 33 disease disease NN cord-017784-4r3fpmlb 145 34 Global Global NNP cord-017784-4r3fpmlb 145 35 Initiative Initiative NNP cord-017784-4r3fpmlb 145 36 for for IN cord-017784-4r3fpmlb 145 37 Chronic Chronic NNP cord-017784-4r3fpmlb 145 38 Obstructive Obstructive NNP cord-017784-4r3fpmlb 145 39 Lung Lung NNP cord-017784-4r3fpmlb 145 40 Diseases Diseases NNPS cord-017784-4r3fpmlb 145 41 . . . cord-017784-4r3fpmlb 146 1 Global global JJ cord-017784-4r3fpmlb 146 2 strategy strategy NN cord-017784-4r3fpmlb 146 3 for for IN cord-017784-4r3fpmlb 146 4 the the DT cord-017784-4r3fpmlb 146 5 diagnosis diagnosis NN cord-017784-4r3fpmlb 146 6 , , , cord-017784-4r3fpmlb 146 7 management management NN cord-017784-4r3fpmlb 146 8 and and CC cord-017784-4r3fpmlb 146 9 prevention prevention NN cord-017784-4r3fpmlb 146 10 of of IN cord-017784-4r3fpmlb 146 11 chronic chronic JJ cord-017784-4r3fpmlb 146 12 obstructive obstructive JJ cord-017784-4r3fpmlb 146 13 pulmonary pulmonary JJ cord-017784-4r3fpmlb 146 14 disease disease NN cord-017784-4r3fpmlb 146 15 Infection infection NN cord-017784-4r3fpmlb 146 16 in in IN cord-017784-4r3fpmlb 146 17 the the DT cord-017784-4r3fpmlb 146 18 pathogenesis pathogenesis NN cord-017784-4r3fpmlb 146 19 and and CC cord-017784-4r3fpmlb 146 20 course course NN cord-017784-4r3fpmlb 146 21 of of IN cord-017784-4r3fpmlb 146 22 chronic chronic JJ cord-017784-4r3fpmlb 146 23 obstructive obstructive JJ cord-017784-4r3fpmlb 146 24 pulmonary pulmonary JJ cord-017784-4r3fpmlb 146 25 disease disease NN cord-017784-4r3fpmlb 146 26 Infective Infective NNP cord-017784-4r3fpmlb 146 27 exacerbations exacerbation NNS cord-017784-4r3fpmlb 146 28 of of IN cord-017784-4r3fpmlb 146 29 chronic chronic JJ cord-017784-4r3fpmlb 146 30 bronchitis bronchitis NN cord-017784-4r3fpmlb 146 31 : : : cord-017784-4r3fpmlb 146 32 relation relation NN cord-017784-4r3fpmlb 146 33 between between IN cord-017784-4r3fpmlb 146 34 bacteriologic bacteriologic JJ cord-017784-4r3fpmlb 146 35 etiology etiology NN cord-017784-4r3fpmlb 146 36 and and CC cord-017784-4r3fpmlb 146 37 lung lung NN cord-017784-4r3fpmlb 146 38 function function NN cord-017784-4r3fpmlb 147 1 The the DT cord-017784-4r3fpmlb 147 2 role role NN cord-017784-4r3fpmlb 147 3 of of IN cord-017784-4r3fpmlb 147 4 atypical atypical JJ cord-017784-4r3fpmlb 147 5 pathogens pathogen NNS cord-017784-4r3fpmlb 147 6 in in IN cord-017784-4r3fpmlb 147 7 exacerbations exacerbation NNS cord-017784-4r3fpmlb 147 8 of of IN cord-017784-4r3fpmlb 147 9 chronic chronic JJ cord-017784-4r3fpmlb 147 10 obstructive obstructive JJ cord-017784-4r3fpmlb 147 11 pulmonary pulmonary JJ cord-017784-4r3fpmlb 147 12 disease disease NN cord-017784-4r3fpmlb 147 13 Infectious infectious JJ cord-017784-4r3fpmlb 147 14 etiology etiology NN cord-017784-4r3fpmlb 147 15 of of IN cord-017784-4r3fpmlb 147 16 acute acute JJ cord-017784-4r3fpmlb 147 17 exacerbations exacerbation NNS cord-017784-4r3fpmlb 147 18 of of IN cord-017784-4r3fpmlb 147 19 chronic chronic JJ cord-017784-4r3fpmlb 147 20 bronchitis bronchitis NN cord-017784-4r3fpmlb 147 21 Prevalence prevalence NN cord-017784-4r3fpmlb 147 22 of of IN cord-017784-4r3fpmlb 147 23 viral viral JJ cord-017784-4r3fpmlb 147 24 infection infection NN cord-017784-4r3fpmlb 147 25 detected detect VBN cord-017784-4r3fpmlb 147 26 by by IN cord-017784-4r3fpmlb 147 27 PCR PCR NNP cord-017784-4r3fpmlb 147 28 and and CC cord-017784-4r3fpmlb 147 29 RT RT NNP cord-017784-4r3fpmlb 147 30 - - HYPH cord-017784-4r3fpmlb 147 31 PCR PCR NNP cord-017784-4r3fpmlb 147 32 in in IN cord-017784-4r3fpmlb 147 33 patients patient NNS cord-017784-4r3fpmlb 147 34 with with IN cord-017784-4r3fpmlb 147 35 acute acute JJ cord-017784-4r3fpmlb 147 36 exacerbation exacerbation NN cord-017784-4r3fpmlb 147 37 of of IN cord-017784-4r3fpmlb 147 38 COPD COPD NNP cord-017784-4r3fpmlb 147 39 : : : cord-017784-4r3fpmlb 147 40 a a DT cord-017784-4r3fpmlb 147 41 systematic systematic JJ cord-017784-4r3fpmlb 147 42 review review NN cord-017784-4r3fpmlb 147 43 Sputum sputum NN cord-017784-4r3fpmlb 147 44 colour colour NN cord-017784-4r3fpmlb 147 45 and and CC cord-017784-4r3fpmlb 147 46 bacteria bacteria NNS cord-017784-4r3fpmlb 147 47 in in IN cord-017784-4r3fpmlb 147 48 chronic chronic JJ cord-017784-4r3fpmlb 147 49 bronchitis bronchitis NN cord-017784-4r3fpmlb 147 50 exacerbations exacerbation NNS cord-017784-4r3fpmlb 147 51 : : : cord-017784-4r3fpmlb 147 52 a a DT cord-017784-4r3fpmlb 147 53 pooled pool VBN cord-017784-4r3fpmlb 147 54 analysis analysis NN cord-017784-4r3fpmlb 147 55 Pathogen pathogen NN cord-017784-4r3fpmlb 147 56 - - HYPH cord-017784-4r3fpmlb 147 57 directed direct VBN cord-017784-4r3fpmlb 147 58 therapy therapy NN cord-017784-4r3fpmlb 147 59 in in IN cord-017784-4r3fpmlb 147 60 acute acute JJ cord-017784-4r3fpmlb 147 61 exacerbations exacerbation NNS cord-017784-4r3fpmlb 147 62 of of IN cord-017784-4r3fpmlb 147 63 COPD COPD NNP cord-017784-4r3fpmlb 147 64 Pneumonia Pneumonia NNP cord-017784-4r3fpmlb 147 65 in in IN cord-017784-4r3fpmlb 147 66 the the DT cord-017784-4r3fpmlb 147 67 very very RB cord-017784-4r3fpmlb 147 68 old old JJ cord-017784-4r3fpmlb 147 69 Community community NN cord-017784-4r3fpmlb 147 70 - - HYPH cord-017784-4r3fpmlb 147 71 acquired acquire VBN cord-017784-4r3fpmlb 147 72 pneumonia pneumonia NN cord-017784-4r3fpmlb 147 73 in in IN cord-017784-4r3fpmlb 147 74 very very RB cord-017784-4r3fpmlb 147 75 elderly elderly JJ cord-017784-4r3fpmlb 147 76 patients patient NNS cord-017784-4r3fpmlb 147 77 : : : cord-017784-4r3fpmlb 147 78 causative causative JJ cord-017784-4r3fpmlb 147 79 organisms organism NNS cord-017784-4r3fpmlb 147 80 , , , cord-017784-4r3fpmlb 147 81 clinical clinical JJ cord-017784-4r3fpmlb 147 82 characteristics characteristic NNS cord-017784-4r3fpmlb 147 83 , , , cord-017784-4r3fpmlb 147 84 and and CC cord-017784-4r3fpmlb 147 85 outcomes outcome NNS cord-017784-4r3fpmlb 148 1 Bacterial bacterial JJ cord-017784-4r3fpmlb 148 2 pneumonia pneumonia NN cord-017784-4r3fpmlb 148 3 in in IN cord-017784-4r3fpmlb 148 4 the the DT cord-017784-4r3fpmlb 148 5 elderly elderly JJ cord-017784-4r3fpmlb 148 6 : : : cord-017784-4r3fpmlb 149 1 the the DT cord-017784-4r3fpmlb 149 2 observations observation NNS cord-017784-4r3fpmlb 149 3 of of IN cord-017784-4r3fpmlb 149 4 Sir Sir NNP cord-017784-4r3fpmlb 149 5 William William NNP cord-017784-4r3fpmlb 149 6 Osler Osler NNP cord-017784-4r3fpmlb 149 7 in in IN cord-017784-4r3fpmlb 149 8 retrospect retrospect JJ cord-017784-4r3fpmlb 149 9 Community Community NNP cord-017784-4r3fpmlb 149 10 - - HYPH cord-017784-4r3fpmlb 149 11 acquired acquire VBN cord-017784-4r3fpmlb 149 12 pneumonia pneumonia NN cord-017784-4r3fpmlb 149 13 requiring require VBG cord-017784-4r3fpmlb 149 14 hospitalization hospitalization NN cord-017784-4r3fpmlb 149 15 among among IN cord-017784-4r3fpmlb 149 16 U.S. U.S. NNP cord-017784-4r3fpmlb 149 17 adults adult NNS cord-017784-4r3fpmlb 150 1 Pneumonia pneumonia NN cord-017784-4r3fpmlb 150 2 in in IN cord-017784-4r3fpmlb 150 3 the the DT cord-017784-4r3fpmlb 150 4 elderly elderly JJ cord-017784-4r3fpmlb 150 5 : : : cord-017784-4r3fpmlb 150 6 a a DT cord-017784-4r3fpmlb 150 7 review review NN cord-017784-4r3fpmlb 150 8 of of IN cord-017784-4r3fpmlb 150 9 the the DT cord-017784-4r3fpmlb 150 10 epidemiology epidemiology NN cord-017784-4r3fpmlb 150 11 , , , cord-017784-4r3fpmlb 150 12 pathogenesis pathogenesis NN cord-017784-4r3fpmlb 150 13 , , , cord-017784-4r3fpmlb 150 14 microbiology microbiology NN cord-017784-4r3fpmlb 150 15 , , , cord-017784-4r3fpmlb 150 16 and and CC cord-017784-4r3fpmlb 150 17 clinical clinical JJ cord-017784-4r3fpmlb 150 18 features feature VBZ cord-017784-4r3fpmlb 150 19 Aspiration aspiration NN cord-017784-4r3fpmlb 150 20 - - HYPH cord-017784-4r3fpmlb 150 21 related relate VBN cord-017784-4r3fpmlb 150 22 pulmonary pulmonary JJ cord-017784-4r3fpmlb 150 23 syndromes syndrome NNS cord-017784-4r3fpmlb 151 1 Guidelines guideline NNS cord-017784-4r3fpmlb 151 2 for for IN cord-017784-4r3fpmlb 151 3 the the DT cord-017784-4r3fpmlb 151 4 management management NN cord-017784-4r3fpmlb 151 5 of of IN cord-017784-4r3fpmlb 151 6 community community NN cord-017784-4r3fpmlb 151 7 - - HYPH cord-017784-4r3fpmlb 151 8 acquired acquire VBN cord-017784-4r3fpmlb 151 9 pneumonia pneumonia NN cord-017784-4r3fpmlb 151 10 in in IN cord-017784-4r3fpmlb 151 11 the the DT cord-017784-4r3fpmlb 151 12 elderly elderly JJ cord-017784-4r3fpmlb 151 13 patient patient NN cord-017784-4r3fpmlb 151 14 Infectious Infectious NNP cord-017784-4r3fpmlb 151 15 Diseases Diseases NNPS cord-017784-4r3fpmlb 151 16 Society Society NNP cord-017784-4r3fpmlb 151 17 of of IN cord-017784-4r3fpmlb 151 18 America/ america/ JJ cord-017784-4r3fpmlb 151 19 American American NNP cord-017784-4r3fpmlb 151 20 Thoracic Thoracic NNP cord-017784-4r3fpmlb 151 21 Society Society NNP cord-017784-4r3fpmlb 151 22 consensus consensus NN cord-017784-4r3fpmlb 151 23 guidelines guideline NNS cord-017784-4r3fpmlb 151 24 on on IN cord-017784-4r3fpmlb 151 25 the the DT cord-017784-4r3fpmlb 151 26 management management NN cord-017784-4r3fpmlb 151 27 of of IN cord-017784-4r3fpmlb 151 28 community community NN cord-017784-4r3fpmlb 151 29 - - HYPH cord-017784-4r3fpmlb 151 30 acquired acquire VBN cord-017784-4r3fpmlb 151 31 pneumonia pneumonia NN cord-017784-4r3fpmlb 151 32 in in IN cord-017784-4r3fpmlb 151 33 adults adult NNS cord-017784-4r3fpmlb 151 34 Guidelines Guidelines NNPS cord-017784-4r3fpmlb 151 35 for for IN cord-017784-4r3fpmlb 151 36 the the DT cord-017784-4r3fpmlb 151 37 management management NN cord-017784-4r3fpmlb 151 38 of of IN cord-017784-4r3fpmlb 151 39 communityacquired communityacquired JJ cord-017784-4r3fpmlb 151 40 pneumonia pneumonia NN cord-017784-4r3fpmlb 151 41 in in IN cord-017784-4r3fpmlb 151 42 adults adult NNS cord-017784-4r3fpmlb 152 1 : : : cord-017784-4r3fpmlb 152 2 update update VB cord-017784-4r3fpmlb 152 3 Guidelines guideline NNS cord-017784-4r3fpmlb 152 4 for for IN cord-017784-4r3fpmlb 152 5 the the DT cord-017784-4r3fpmlb 152 6 management management NN cord-017784-4r3fpmlb 152 7 of of IN cord-017784-4r3fpmlb 152 8 adult adult NN cord-017784-4r3fpmlb 152 9 lower low JJR cord-017784-4r3fpmlb 152 10 respiratory respiratory JJ cord-017784-4r3fpmlb 152 11 tract tract NN cord-017784-4r3fpmlb 152 12 infections infection NNS cord-017784-4r3fpmlb 152 13 Blood blood NN cord-017784-4r3fpmlb 152 14 biomarkers biomarker NNS cord-017784-4r3fpmlb 152 15 for for IN cord-017784-4r3fpmlb 152 16 personalized personalized JJ cord-017784-4r3fpmlb 152 17 treatment treatment NN cord-017784-4r3fpmlb 152 18 and and CC cord-017784-4r3fpmlb 152 19 patient patient NN cord-017784-4r3fpmlb 152 20 management management NN cord-017784-4r3fpmlb 152 21 decisions decision NNS cord-017784-4r3fpmlb 152 22 in in IN cord-017784-4r3fpmlb 152 23 community community NN cord-017784-4r3fpmlb 152 24 - - HYPH cord-017784-4r3fpmlb 152 25 acquired acquire VBN cord-017784-4r3fpmlb 152 26 pneumonia pneumonia NN cord-017784-4r3fpmlb 152 27 Antibacterial antibacterial JJ cord-017784-4r3fpmlb 152 28 agents agent NNS cord-017784-4r3fpmlb 152 29 in in IN cord-017784-4r3fpmlb 152 30 the the DT cord-017784-4r3fpmlb 152 31 elderly elderly JJ