title: Re-evaluation of the therapy of severe pneumonia caused by Streptococcus pneumoniae.
abstract: Pneumonia caused by Streptococcus pneumoniae is the most deadly form of community-acquired pneumonia. The death rate of bacteremic pneumococcal pneumonia has remained constant over the past 50 years. Several retrospective reviews of bacteremic pneumococcal pneumonia suggest that dual therapy with a beta-lactam and a macrolide antimicrobial agent is associated with a lower case fatality rate than therapy with a beta-lactam alone. These studies are reviewed, potential mechanisms are suggested, and future studies are discussed.
authors.affiliation: Department of Internal Medicine, Ohio State University College of Medicine and Public Health, Columbus, OH 43210, USA. jplouffe@columbus.rr.com
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Plouffe
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Martin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology; D002511:Cephalosporins / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000401:mortality; D004198:Disease Susceptibility; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D018942:Macrolides