Clinical efficacy of newer agents in short-duration therapy for community-acquired pneumonia.

Clinical efficacy of newer agents in short-duration therapy for community-acquired pneumonia.

File Thomas M Jr

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2004

2004-09

Streptococcus pneumoniae, the most important respiratory tract pathogen implicated in community-acquired pneumonia (CAP), is becoming increasingly resistant in vitro to the beta -lactams and macrolides, and fluoroquinolone resistance has been detected. A growing body of evidence suggests that prolonged antimicrobial use may contribute directly and indirectly to increased antimicrobial resistance among common respiratory pathogens. Long-term exposure to antimicrobial agents, especially less-potent agents, directly increases selection pressure for resistance. Indirectly, poor patient compliance, multiple daily dosing, and the increased risk of adverse events further complicate the resistance issue and diminish the efficacy of long-term antimicrobial use. Controlled clinical trials addressing the appropriate duration of therapy for CAP are lacking. However, available data suggest that with appropriate antibiotic selection, based on appropriate spectrum, potency, and pharmacokinetic/pharmacodynamic profile, lower respiratory tract infections in outpatients can be successfully treated in \textless7 days rather than the 7-14 days currently recommended.

Anti-Infective Agents/*therapeutic use; Community-Acquired Infections/*drug therapy/microbiology; Humans; Pneumonia/*drug therapy/microbiology; Streptococcus pneumoniae/drug effects/isolation & purification; Treatment Outcome

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S159–164

39 Suppl 3