1 40 2 Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. URL Address <a href="http://doi.org/10.18553/jmcp.2009.15.s2.5" target="_blank" rel="noreferrer noopener">http://doi.org/10.18553/jmcp.2009.15.s2.5</a> Pages S5–11 Issue 2 Volume 15 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The science of selecting antimicrobials for community-acquired pneumonia (CAP). Publisher An entity responsible for making the resource available Journal of managed care pharmacy : JMCP Date A point or period of time associated with an event in the lifecycle of the resource 2009 2009-03 Subject The topic of the resource Humans; Microbial Sensitivity Tests; Anti-Bacterial Agents/*therapeutic use; Practice Guidelines as Topic; Streptococcus pneumoniae/isolation & purification; Community-Acquired Infections/drug therapy; *Drug Resistance; beta-Lactams/*therapeutic use; Chlamydophila pneumoniae/isolation & purification; Fluoroquinolones/*therapeutic use; Legionnaires' Disease/drug therapy; Macrolides/*therapeutic use; Pneumonia; Bacterial; Drug Therapy; Bacterial/*drug therapy; Combination Creator An entity primarily responsible for making the resource File Thomas M Description An account of the resource BACKGROUND: Among infectious diseases, community-acquired pneumonia (CAP) is the leading cause of death in the United States and is associated with a substantial economic burden to the health care system. Initiating appropriate empiric therapy can be challenging given elevated resistance rates among Streptococcus pneumoniae strains. OBJECTIVE: To present current recommendations for management of CAP with respect to (a) choosing the appropriate site of care, and (b) antimicrobial selection based on bacterial etiology and the prevalence of resistance. SUMMARY: Mortality prediction tools, such as the PORT (Pneumonia Outcomes Research Team) Severity Index, CURB-65 (Confusion, Urea concentration, Respiratory rate, Blood pressure, and age\textgreater65), or CRB-65 (Confusion, Respiratory rate, Blood pressure, and age\textgreater65), can be invaluable in determining which CAP patients require hospitalization. These tools can help reduce overall costs for CAP by limiting hospitalizations of low-risk patients. S. pneumoniae remains the most common causative pathogen for CAP across all disease severities, and elevated rates of resistance to penicillin and macrolides can hinder selection of appropriate antimicrobial therapy. Antimicrobial resistance can impact clinical outcomes, including increasing the risk of treatment failure and breakthrough bacteremia. Current management guidelines recommend monotherapy with a respiratory fluoroquinolone or combination therapy with a beta-lactam and a macrolide (for patients admitted to the general medical ward) or with a beta-lactam and either a respiratory fluoroquinolone or a macrolide (for patients admitted to the intensive care unit [ICU] and who do not have risk factors for methicillin-resistant S. aureus or Pseudomonas). Optimized dosing regimens aim to ensure that pharmacokinetic and pharmacodynamic targets are met to achieve successful clinical outcomes and minimize resistance development. CONCLUSION: Effective management of patients with CAP requires selection of the proper site of care and appropriate empiric antimicrobial. Given the elevated rates of resistance among S. pneumoniae, local resistance patterns must be considered when choosing empiric therapy. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.18553/jmcp.2009.15.s2.5" target="_blank" rel="noreferrer noopener">10.18553/jmcp.2009.15.s2.5</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s). *Drug Resistance 2009 Anti-Bacterial Agents/*therapeutic use Bacterial Bacterial/*drug therapy beta-Lactams/*therapeutic use Chlamydophila pneumoniae/isolation & purification Combination Community-Acquired Infections/drug therapy Department of Internal Medicine Drug Therapy File Thomas M Fluoroquinolones/*therapeutic use Humans Journal of managed care pharmacy : JMCP Legionnaires' Disease/drug therapy Macrolides/*therapeutic use Microbial Sensitivity Tests NEOMED College of Medicine Pneumonia Practice Guidelines as Topic Streptococcus pneumoniae/isolation & purification Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. URL Address <a href="http://doi.org/10.1111/j.1469-0691.2006.01395.x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/j.1469-0691.2006.01395.x</a> Pages 31–41 Volume 12 Suppl 3 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Clinical implications and treatment of multiresistant Streptococcus pneumoniae pneumonia. Publisher An entity responsible for making the resource available Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases Date A point or period of time associated with an event in the lifecycle of the resource 2006 2006-05 Subject The topic of the resource Anti-Infective Agents/*therapeutic use; Bacterial; Community-Acquired Infections/*drug therapy/economics/*microbiology; Drug Resistance; Fluoroquinolones/*therapeutic use; Humans; Ketolides/therapeutic use; Multiple; Pneumococcal/*drug therapy/economics/*microbiology; Pneumonia; Streptococcus pneumoniae/*growth & development Creator An entity primarily responsible for making the resource File T M Jr Description An account of the resource Streptococcus pneumoniae is the leading bacterial cause of community-acquired respiratory tract infections. Prior to the 1970s this pathogen was uniformly susceptible to penicillin and most other antimicrobials. However, since the 1990s there has been a significant increase in drug-resistant Streptococcus pneumoniae (DRSP) due, in large part, to increased use of antimicrobials. The clinical significance of this resistance is not definitely established, but appears to be most relevant to specific MICs for specific antimicrobials. Certain beta-lactams (amoxicillin, cefotaxime, ceftriaxone), the respiratory fluoroquinolones, and telithromycin are among several agents that remain effective against DRSP. Continued surveillance studies, appropriate antimicrobial usage campaigns, stratification of patients based on known risk factors for resistance, and vaccination programmes are needed to appropriately manage DRSP and limit its spread. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1111/j.1469-0691.2006.01395.x" target="_blank" rel="noreferrer noopener">10.1111/j.1469-0691.2006.01395.x</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s). 2006 Anti-Infective Agents/*therapeutic use Bacterial Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases Community-Acquired Infections/*drug therapy/economics/*microbiology Department of Internal Medicine Drug Resistance File T M Jr Fluoroquinolones/*therapeutic use Humans Ketolides/therapeutic use Multiple NEOMED College of Medicine Pneumococcal/*drug therapy/economics/*microbiology Pneumonia Streptococcus pneumoniae/*growth & development