Makharynska O. Community-acquired pneumonia in patients with diabetes mellitus type 2: clinical features and treatment

We observed 131 patients: study group-82 patients with community-acquired pneumonia (CAP) and type 2 diabetes mellitus (DM), the control group-49 patients with community-acquired pneumonia. Patients with type 2 diabetes associated with significantly increasing of duration of ABT and length of stay in hospital opposite the control group. The number of cases of pleural effusion, which leads to a more severe course of the CAP, on x-rays was higher in patients with DM. The number of leukocytes in the beginning of the disease is directly related to the risk of clinical failure of treatment of CAP in patients with type 2 diabetes. The peculiarity of the CAP in individuals with increased hyperglycemia (above the median of 9.9 mmol/l) compared with patients with moderate hyperglycemia is a long sputum production and long-term preservation of coughing. Most patients with moderate hyperglycemia recover in 10±2 days of treatment, while most patients with elevated hyperglycemia in these terms occurs only improvement. Contents of inflammatory (IL-beta, IL-8, TNF-alpfa), inflammatory (IL-10) cytokines and markers of inflammation (CRP) in patients with CAP and concomitant diabetes type 2 without it is neither at the beginning of treatment, no 48-72 hours later. The effectiveness of the combined ABT not exceed the monotherapy of mild CAP in patients with type 2 diabetes, but the duration of ABT and its cost was significantly higher in the case of a combination of antibiotics. Use antibiotics at the CAP in patients with type 2 diabetes before hospitalization is associated with an increase in the proportion of patients recovering after 10±2 days of hospital stay. To identify the factors of treatment's negative outcome was developed predictive equation for patients with mild CAP and concomitant DM.