title: Macrolide therapy of pneumonia: is it necessary, and how does it help?
abstract: OBJECTIVE
  An update and literature review assessing the implications for use of macrolide therapy for patients with pneumonia is very relevant. Multiple studies have focused on assessing the efficacy, clinical effectiveness and clinical risks associated with the use of macrolides.
  
  
  RESULTS
  The scope of this review is on recently published literature regarding the use of macrolides in patients with pneumonia. Recent evidence suggests that macrolides may benefit several populations of patients with pneumonia that includes ambulatory care, hospitalized patients with nonsevere pneumonia and severe pneumonia patients requiring ICU admission. In addition, there is benefit among patients with pneumococcal pneumonia, particularly those patients hospitalized with severe disease. The contradictory results that emerged from recent randomized controlled trials testing the efficacy of macrolide are discussed. Important remarks are made to the risks of cardiovascular events related to the use of macrolides and the clinical implications for care.
  
  
  CONCLUSIONS
  A careful decision on the use of macrolides in patients with pneumonia will need to balance the possible beneficial effects and the risks linked to their use.
authors.affiliation: aSouth Texas Veterans Healthcare System, University of Texas Health Science Center, San Antonio, Texas, USA bIntensive Care Unit, Hospital Universitario Dr Negrín, CIBERES, Barranco de la Ballena s/n, Las Palmas de Gran Canaria, Spain cMultidisciplinary Care Research Organization, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland.
authors.forename: Marcos I
authors.initials: MI
authors.lastname: Restrepo
authors.forename: Jordi
authors.initials: J
authors.lastname: Sole-Violan
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martin-Loeches
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D018942:Macrolides / Q000009:adverse effects / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides