Journal Article

Antibiotic Treatment Strategies for Community-Acquired Pneumonia in Adults

Kluytmans, Jan A.J.W, Prins, Jan M, Boersma, Wim G, Oosterheert, Jan J, Hoepelman, Andy I.M, Bonten, Marc J.M, Postma, Douwe F, van Elden, Leontine J.R, Thijsen, Steven F.T, van Werkhoven, Cornelis H, Compaijen, Clara J, van der Wall, Eva

2015

Overview

Antimicrobial choices for community-acquired pneumonia in hospitalized patients who do not require ICU-level care continue to be debated. In this trial, empirical beta-lactam–based therapy with or without a macrolide was compared with fluoroquinolones as initial treatment. Community-acquired pneumonia (CAP) is a leading cause of hospitalization and death worldwide. 1 – 3 Most guidelines recommend that antibiotic treatment be based on the severity of disease at presentation, assessed either on the basis of the level of care needed or on the basis of a prognostic risk score. 4 – 6 For patients with clinically suspected CAP who are admitted to a non–intensive-care-unit (ICU) ward, guidelines recommend either combination therapy with a beta-lactam plus a macrolide or plus ciprofloxacin or monotherapy with moxifloxacin or levofloxacin for empirical treatment. These guidelines have increased the use of macrolides and fluoroquinolones, although these antibiotic classes . . .

• Publisher: Massachusetts Medical Society
• Subject: Administration, Oral / Adult / Adults / Aged / Anti-Bacterial Agents - therapeutic use / Antibiotics / beta-Lactams - therapeutic use / Community-Acquired Infections - drug therapy / Community-Acquired Infections - mortality / Cross-Over Studies / Drug therapy / Drug Therapy, Combination / Female / Fluoroquinolones - therapeutic use / Humans / Intention to Treat Analysis / Length of Stay / Macrolides - therapeutic use / Male / Middle Aged / Mortality / Motivation / Patients / Pneumonia / Pneumonia, Bacterial - drug therapy / Pneumonia, Bacterial - mortality