[Empiric therapy of community-acquired pneumonia: a transatlantic controversy].
North American and European guidelines for empiric antimicrobial therapy of community-acquired pneumonia differ. This stems from a different mechanism of pneumococcal resistance to macrolides, and a different perception of the need to cover atypical germs. For mild cases, two recent meta-analyses conclude that this coverage is not associated with any benefit. For more severe pneumonias, data are scarce and experts generally recommend wide coverage. Except for particular situations, the new fluoroquinolones should not represent the first-line therapy because of rapidly growing resistance to these antibiotics.
Garin
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Service de médecine interne générale, Département de médecine interne, Faculté de médecine de Genève, HUG. Nicolas.Garin@hcuge.ch
Nendaz
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D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D005060:Europe; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D007769:Lactams / Q000627:therapeutic use; D018942:Macrolides / Q000627:therapeutic use; D009656:North America; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D017410:Practice Guidelines as Topic
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D007769:Lactams; D018942:Macrolides