title: Treatment of pneumonia in patients at risk of infection with gram-negative bacilli.
abstract: Patients with a history of chronic debilitating disease due to a variety of causes are known to be at risk for infection with coliform gram-negative bacilli when they present with community-acquired pneumonia. Empiric treatment with broad-spectrum parenteral antibiotics is often begun in such patients pending the result of blood and other cultures. The optimal duration of broad-spectrum empiric therapy in such patients when cultures fail to reveal a specific pathogen is unknown. Review was made of the charts of 131 patients with community-acquired pneumonia admitted to the hospital and treated with broad-spectrum parenteral antibiotics in whom a specific pathogen was never isolated. Overall, 89 percent of these patients were cured without complication or relapse. Patients receiving broad-spectrum therapy for four days or less due to rapid clinical improvement had a successful outcome in 95 percent of cases. It is concluded that broad-spectrum parenteral antibiotic therapy can safely be abbreviated provided response to therapy is prompt.
authors.affiliation: Department of Internal Medicine, University of Texas Health Science Center, Southwestern Medical School, Dallas 75235-9034.
authors.forename: J L
authors.initials: JL
authors.lastname: McGehee
authors.forename: S D
authors.initials: SD
authors.lastname: Podnos
authors.forename: A K
authors.initials: AK
authors.lastname: Pierce
authors.forename: J C
authors.initials: JC
authors.lastname: Weissler
mesh_terms: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006090:Gram-Negative Bacteria; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents