Acute Pneumonia: Infection Or Inflammation in the Lung? - Acute Pneumonia: Infection Or Inflammation in the Lung? - Open Access Pub

DOI10.14302/issn.2642-9241.jrd-19-2773 The question in the title of this letter is not a comparison of terms. The answer to this question is fundamental to substantiate the principles of care and further results of treatment of the disease. The choice of the answer to this dilemma determines the strategy for further directions in solving the problem of acute pneumonia (AP). The validity and correctness of this choice will affect not only the effectiveness of further actions and efforts, but also the fate of many patients. To come to a meaningful and reasoned view of the essence of AP, it is enough to analyze the arguments and facts accumulated by medical science and practice. Over the past decades, the whole strategy in solving the problem of AP is based on the infectious nature of the disease. Modern medicine considers the microbial factor as the main cause of the emergence and subsequent development of this nosology. It is logical that such an interpretation of the nature of AP dictates the concentration of efforts primarily on antimicrobial therapy. From the standpoint of the infectious onset of the disease, differences in the severity of clinical manifestations of AP are explained by the virulence of a specific pathogen, and the lack of effectiveness of modern antibiotic therapy is associated with the lack of methods for rapid and accurate bacteriological testing. These explanations of the features of AP from the point of view of infection look at first glance reasoned, and an attempt to revise this point of view can be regarded as ignorance and incompetence. The possibility of such a revision of views contradicts the principles of modern medical education in the section AP and job requirements that determine the volume and sequence of medical care in the treatment of this category of patients. However, the need for such an audit is inevitable, as the modern understanding of the nature of AP has many contradictions and declarative statements without a sufficient base of objective arguments. The formation of views on AP as an infectious process was put with the beginning of the use of antibiotics and this transformation, from my point of view, for many years was paradoxical. On the one hand, each new generation of doctors was brought up in the spirit of the increasing role of antibiotics in everyday practice, which ultimately led to the creation of the brand of initial AP treatment as "antibiotics alone". But, on the other hand, the decline in the effectiveness of antibiotic therapy, the constant search for new drugs and the emergence of