[Optimal strategies for the treatment of senile pneumonia]

China has become an ageing society. Senile pneumonia is on the rise and is characterized by an insidious onset and rapid progression. Senile pneumonia is difficult to treat and has a high mortality. Therefore, the Respiratory Committee of Chinese Geriatrics Society has launched the "Chinese expert consensus on the diagnosis and treatment of senile pneumonia (2024 Edition)".The "consensus" has proposed the following treatment principles. As soon as possible the diagnosis is made, the appropriate empirical antimicrobial therapy should be started. Antimicrobials that are safe and have fewer drug-drug interactions should be preferred on the premise of efficacy. After 48 to 72 hours of initial treatment, clinical efficacy should be assessed and antimicrobial therapy should be optimized.Initial empirical antimicrobial therapy should cover the most common pathogens. The pathogen spectrum in senile pneumonia is different from that in younger patients. The initial empirical antimicrobial therapy should be based on the patient's underlying diseases, the risk of multidrug-resistant (MDR) bacteria and the severity of pneumonia. Individualized therapy is important for senile pneumonia.Therapeutic effect should be evaluated 48-72 hours after the initial therapy, including clinical manifestations and laboratory tests. At the same time, the patient's cognition, diet, sleep, and organ function should also be evaluated. If the initial treatment fails, the reasons should be quickly identified, and the treatment should be adjusted accordingly.In addition to anti-infective therapy, a comprehensive approach should be considered, including support of organ function, cautious use of glucocorticoids, sputum drainage, early and appropriate rehydration and nutritional support.