title: Evidence-based guidelines for treatment of bacterial respiratory tract infections in the era of antibiotic resistance.
abstract: Antimicrobial resistance in bacterial respiratory tract pathogens is a rapidly evolving and increasingly disconcerting problem. Major factors that have contributed to resistance are inappropriate prescribing of antibiotics for viral infections and the use of antibiotics with poor activity. The treatment of respiratory tract infections is significantly affected by resistance in organisms such as Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Resistance to beta-lactams, sulfonamides, and macrolides continues to rise. Evidence-based guidelines, founded on clinical and bacteriological outcomes, are imperative to treat patients effectively, to limit the spread of these pathogens, and to minimize further development of resistance. Pharmacokinetic and pharmacodynamic parameters have recently been shown to correlate with clinical outcome, and offer a more rational approach to predicting antimicrobial efficacy and determining clinically relevant susceptibility breakpoints.
authors.affiliation: Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Jacobs
authors.forename: W
authors.initials: W
authors.lastname: Weinberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000145:classification; D017281:Cost of Illness; D019468:Disease Management; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000592:standards*; D019317:Evidence-Based Medicine; D006193:Haemophilus influenzae / Q000187:drug effects / Q000821:virology; D006801:Humans; D008826:Microbial Sensitivity Tests; D001936:Moraxella catarrhalis / Q000187:drug effects / Q000821:virology; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000821:virology; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents