OPTIMIZING REHABILITATION OUTCOMES IN ELDERLY STROKE PATIENTS WITH NOSOCOMIAL PNEUMONIA: EFFECTS OF COMBINED MEROPENEM AND ENTERAL NUTRITION ON INFLAMMATORY AND IMMUNE MARKERS

Abstract

Objective: This study investigates the impact of combining meropenem with enteral nutrition on immune response and inflammation, specifically focusing on Immunoglobulin M (IgM), Tumor Necrosis Factor-alpha (TNF-α), and Surfactant Protein A (SPA) levels, in elderly stroke patients with nosocomial pneumonia. The study also examines the influence of this treatment combination on clinical outcomes related to pneumonia severity. Methods: Ninety elderly patients with hospital-acquired pneumonia following a stroke were enrolled from January 2022 to February 2023. They were randomized into two groups, with 45 patients in each. Both groups received standard care including meropenem. The study group additionally received enteral nutrition. The effects of these interventions on IgM, TNF-α, SPA levels, and the Clinical Pulmonary Infection Score (CPIS) were assessed pre- and post-treatment. Results: Initially, there were no significant differences between the study and control groups in terms of IgM, TNF-α, and SPA levels. Post-treatment, the study group showed significant reductions in these markers compared to the control group (P < 0.05). Similarly, the CPIS was significantly lower in the study group post-treatment, indicating a better clinical response to pneumonia. The treatment effects were consistent across patients regardless of the initial severity of their condition. Conclusion: The addition of enteral nutrition to standard antibiotic treatment with meropenem in elderly stroke patients with nosocomial pneumonia significantly enhances the immune response and reduces inflammation, as evidenced by decreases in IgM, TNF-α, and SPA levels. Furthermore, this combination treatment improves clinical outcomes as measured by the CPIS. These findings suggest that integrating nutritional support with medical treatment can be crucial in the rehabilitation process, potentially accelerating recovery and improving overall outcomes in elderly patients recovering from stroke and pneumonia. Such approaches are valuable in sports medicine, where optimizing recovery processes and reducing complications are pivotal for the elderly athletic population.