title: Antibiotic stewardship in community-acquired pneumonia.
abstract: Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Areas covered: Several elements can be applied to antibiotic stewardship strategies for CAP in order to maintain or improve patient outcomes. In this regard, antibiotic de-escalation, duration of antibiotic treatment, adherence to CAP guidelines recommendations about empirical treatment, and switching from intravenous to oral antibiotic therapy may each be relevant in this context. Antimicrobial stewardship strategies, such as prospective audit with intervention and feedback, clinical pathways, and dedicated multidisciplinary teams, that have included some of these elements have demonstrated improvements in antimicrobial use for CAP without negatively affecting clinical outcomes. Expert commentary: Although there are a limited number of randomized clinical studies addressing antimicrobial stewardship strategies in CAP, there is evidence that antibiotic stewardship initiatives can be securely applied, providing benefits to both healthcare systems and patients.
authors.affiliation: a Faculty of Medicine, Health Sciences Division , Hospital Universidad del Norte and Universidad del Norte , Barranquilla , Colombia.
authors.forename: Diego
authors.initials: D
authors.lastname: Viasus
authors.affiliation: a Faculty of Medicine, Health Sciences Division , Hospital Universidad del Norte and Universidad del Norte , Barranquilla , Colombia.
authors.forename: Milly
authors.initials: M
authors.lastname: Vecino-Moreno
authors.affiliation: a Faculty of Medicine, Health Sciences Division , Hospital Universidad del Norte and Universidad del Norte , Barranquilla , Colombia.
authors.forename: Juan M
authors.initials: JM
authors.lastname: De La Hoz
authors.affiliation: b Infectious Disease Department, Hospital Universitari de Bellvitge, IDIBELL, Spanish Network for Research in Infectious Diseases (REIPI), and Clinical Science Department, Faculty of Medicine , University of Barcelona , Barcelona , Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Carratalà
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000382:microbiology; D019468:Disease Management; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D006801:Humans; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D017410:Practice Guidelines as Topic
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic; antimicrobial-resistance; community-acquired pneumonia; outcomes; stewardship