How long should we treat community-acquired pneumonia?
antibacterial response; antibiotic-therapy; antimicrobial therapy; azithromycin; clinical-efficacy; community-acquired pneumonia; double-blind; duration of therapy; Infectious Diseases; practice guidelines; respiratory-tract infections; short-duration therapy; Streptococcus pneumoniae
Purpose of review: The studies, reviewed in this article suggest that a shorter duration of antibiotic therapy is comparable to standard therapy in the treatment of community-acquired pneumonia and promotes reduction of adverse events, microbial resistance, cost, and improved patient compliance. Recent findings: Community-acquired pneumonia has traditionally been treated with a 7-14-day course of antimicrobial therapy. Since there have been few well controlled trials regarding the optimal duration of therapy, however, there has been no consensus on length of therapy among different organizational guidelines. Several recent studies have demonstrated that shorter course antibiotic regimens are effective in the treatment of community-acquired pneumonia. Summary: Short-course antibiotic therapy is equivalent to standard length of therapy for clinical cure and bacterial eradication. Minimization of drug exposure, however, reduces selection pressure for resistant strains, strengthens patient compliance, and potentially reduces adverse events such as Clostridium difficile infections.
Scalera N M; File T M
Current Opinion in Infectious Diseases
2007
2007-04
Journal Article
<a href="http://doi.org/10.1097/QCO.0b013e3280555072" target="_blank" rel="noreferrer noopener">10.1097/QCO.0b013e3280555072</a>
Community-Acquired Pneumonia in Older Adults
community-acquired pneumonia; Geriatrics & Gerontology; Elderly; Vaccine; Antimicrobial therapy; Nursing home-acquired pneumonia; Respiratory pathogens
Community-acquired pneumonia (CAP) is a common disorder with significant morbidity and mortality, particularly for older adults. Risk factors include comorbid conditions commonly found in older patients as well as immunocompromising conditions such as steroid use or administration of anti-TNF agents. While Streptococcus pneumoniae remains the most common cause of CAP in older patients, the microbiology of pneumonia differs somewhat from that of young adults with increased incidence of Staphylococcus aureus and gram-negative bacilli (especially for patients who are residents of nursing homes). The classic features of infections such as fever may not be present in older patients. Antimicrobial therapy is similar to that of younger patients and based on recent guidelines; however, there is an increased need to adjust doses based on the pharmacokinetics of the older population. Prevention includes administration of preventive vaccines and control of comorbid conditions.
Breen T R; File T M
Current Geriatrics Reports
2015
2015-03
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s13670-014-0112-7" target="_blank" rel="noreferrer noopener">10.1007/s13670-014-0112-7</a>
Ventilator-associated pneumonia: gearing towards shorter-course therapy
pneumonia; Infectious Diseases; trial; infection; antibiotic-therapy; resolution; Antimicrobial therapy; duration of therapy; pseudomonas-aeruginosa; ventilator-associated
Purpose of review The studies that are reviewed in this article have all concluded that a shorter duration of antibiotic therapy (7-8 days) may be adequate in the treatment of the majority of patients with ventilator-associated pneumonia, and does not confer an increased incidence of mortality. Recent findings Ventilator-associated pneumonia has traditionally been treated with at least 2 weeks of antimicrobial therapy. With the increasing emergence of multi-drug-resistant pathogens, however, efforts have been directed at minimizing the duration of therapy. Several studies have emerged over the last few years aiming to shorten the duration of antimicrobial therapy for ventilator-associated pneumonia. Summary The minimum effective duration of antibiotic therapy, however, remains unclear. Further studies geared towards determining this are needed.
Chua T D; File T M
Current Opinion in Infectious Diseases
2006
2006-04
Journal Article or Conference Abstract Publication
n/a
Rapid Detection Of Streptococcus Pneumoniae In Community-acquired Pneumonia
adults; antimicrobial therapy; bacteremic pneumococcal pneumonia; cerebrospinal-fluid; diagnosis; infections; Infectious Diseases; management; Microbiology; pneumococcus; pneumonia; polymerase chain-reaction; rapid detection; sputum culture; urinary antigen test
File T M; Kozlov R S
Clinical Microbiology and Infection
2006
2006-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1469-0691.2006.01653.x" target="_blank" rel="noreferrer noopener">10.1111/j.1469-0691.2006.01653.x</a>
Clinical Implications Of 750mg, 5-day Levofloxacin For The Treatment Of Community Acquired Pneumonia
adults; antimicrobial therapy; community-acquired pneumonia; controlled-trial; critical pathway; early switch; General & Internal Medicine; guidelines; levofloxacin; management; oral antibiotics; Research & Experimental Medicine; resolution; short-course; symptom
File T M; Milkovich G; Tennenberg A M; Xiang J X; Khashab M M; Zadeikis N
Current Medical Research and Opinion
2004
2004-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1185/030079904x2558" target="_blank" rel="noreferrer noopener">10.1185/030079904x2558</a>
Optimizing Therapy For Community-acquired Pneumonia With The Goal Of Rapid Resolution Of Illness
adults; antimicrobial therapy; Immunology; Infectious Diseases; management; Microbiology; monotherapy; practice guidelines
File T M; Tan J S
Clinical Infectious Diseases
2005
2005-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1086/498160" target="_blank" rel="noreferrer noopener">10.1086/498160</a>
Focus 2: A Randomized, Double-blinded, Multicentre, Phase Iii Trial Of The Efficacy And Safety Of Ceftaroline Fosamil Versus Ceftriaxone In Community-acquired Pneumonia
2-phase 3; adults; antimicrobial therapy; CABP; CAP; collection; guidelines; Infectious Diseases; integrated analysis; management; Microbiology; penicillin-binding proteins; Pharmacology & Pharmacy; staphylococcus-aureus; streptococcus-pneumoniae; streptococcus-pneumoniae; therapy
Low D E; File T M; Eckburg P B; Talbot G H; Friedland H D; Lee J; Llorens L; Critchley I A; Thye D A; Investigators Focus
Journal of Antimicrobial Chemotherapy
2011
2011-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1093/jac/dkr097" target="_blank" rel="noreferrer noopener">10.1093/jac/dkr097</a>