[Treatment and prevention of pneumococcal pneumonia].
Streptococcus pneumoniae is the most commonly identified pathogen in patients with community-acquired pneumonia. 40% of isolated strains in France are of decreased sensibility to penicillin, two third being multiresistant to antibiotics. However, high doses of some beta-lactams are effective in vivo against the majority of circulating strains (MIC > 2 mg/L). For this reason according to French guidelines amoxicillin (3 g/day) is the first line recommended treatment. Telithromycin is an alternative, or ceftriaxone (1 g/day) in more severe cases. If the level of resistance increases (MIC > 4 mg/L) guidelines would be revisited. Effectiveness of pneumococcal vaccination has been confirmed in cases of bacteriemic pneumococcal pneumonia (elderly patients included). Vaccine is recommended among persons with comorbiditie(s) and 65 years old population.
Léophonte
Paul
P
Service de pneumologie, hôpital Rangueil-Larrey, TSA 50032, 31059 Toulouse. leophonte.p@chu-toulouse.fr
Mazières
Julien
J
D000900:Anti-Bacterial Agents / Q000592:standards / Q000627:therapeutic use*; D006801:Humans; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines