Guidelines for empiric antimicrobial prescribing in community-acquired pneumonia.

Guidelines for empiric antimicrobial prescribing in community-acquired pneumonia.

File Thomas M Jr; Garau Javier; Blasi Francesco; Chidiac Christian; Klugman Keith; Lode Hartmut; Lonks John R; Mandell Lionel; Ramirez Julio; Yu Victor

Chest

2004

2004-05

Empiric antimicrobial prescribing for community-acquired pneumonia remains a challenge, despite the availability of treatment guidelines. A number of key differences exist between North American and European guidelines, mainly in the outpatient setting. The North American approach is to use initial antimicrobial therapy, which provides coverage for Streptococcus pneumoniae plus atypical pathogens. Europeans tend to focus on providing pneumococcal coverage with less emphasis on covering for an atypical pathogen. Ambulatory patients without comorbidity are more likely to receive macrolide therapy in North America, whereas in Europe these patients would probably receive a beta-lactam agent. Major issues that are fundamental to this difference include the importance of providing therapy for atypical pathogens and the clinical significance of macrolide-resistant S pneumoniae. Prospective data are required to evaluate which of these two approaches offers clinical superiority.

Humans; United States; Practice Guidelines as Topic; Canada; Europe; Community-Acquired Infections/drug therapy; Fluoroquinolones/therapeutic use; Lactams/therapeutic use; Macrolides/therapeutic use; Drug Resistance; Pneumonia; Bacterial; Bacterial/*drug therapy

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

1888–1901

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