Optimal treatment strategies for community-acquired pneumonia: non-responders to conventional regimens.
When patients with community-acquired pneumonia (CAP) fail to respond after initiation of empirical therapy, it is necessary for the physician to consider a number of possibilities. The diagnosis should be reviewed, with consideration given to both non-infectious and infectious illnesses. If the diagnosis is correct, the failure may relate to three areas: host-related problems, including overwhelming infection and empyema, pathogen-related problems, including infection caused by an unusual or resistant pathogen, and drug-related problems, including inappropriate dose of drug, poor compliance, malabsorption, and drug interactions. A systematic therapeutic approach including a microbiological evaluation to identify the causative pathogen and its susceptibility will help to ensure that an appropriate antimicrobial agent is used.
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T M
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Department of Internal Medicine, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, USA. FileT@summa-health.org
D000890:Anti-Infective Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008297:Male; D015242:Ofloxacin / Q000627:therapeutic use; D011014:Pneumonia / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D017410:Practice Guidelines as Topic; D013492:Suppuration / Q000188:drug therapy / Q000473:pathology; D017211:Treatment Failure
D000890:Anti-Infective Agents; D015242:Ofloxacin