title: [Community-acquired pneumonia--treatment perspectives in the physician's office].
abstract: In patients with a focal finding on auscultation, a chest radiograph should be performed to confirm pneumonia. The need for hospitalization can be supported objectively with the aid of the Pulmonary Severity Index (PSI) or the CURB score. The most common pathogen of pneumonia is Streptococcus pneumoniae. The choice of appropriate antimicrobial therapy is based on the expected spectrum of pathogens, severity, the risk profile and the patient's history of antimicrobial substance use. In this connection, the progressive development of resistance forbids first-choice recommendations, and "cycling" should be attempted instead. Depending on the regional resistance situation and prior conditions, amoxicillin in combination with a beta-lactamase inhibitor, doxycycline, a macrolide or a ketolide may be considered for treatment purposes. For higher levels of severity, fluorquinolones also have proven value.
authors.affiliation: Klinik für Pneumologie, Beatmungsmedizin und Infektiologie, Bochum.
authors.forename: S
authors.initials: S
authors.lastname: Ewig
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy; D018432:Drug Resistance, Multiple; D006801:Humans; D018410:Pneumonia, Bacterial / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy; D011018:Pneumonia, Pneumococcal / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Behandlungsperspektiven der Pneumonie in der Praxis. Wettlauf mit den Resistenzen.