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Assessing Options for Pneumonia Hospitalizations

Assessing Options for Pneumonia Hospitalizations

Community-acquired pneumonia (CAP) affects approximately 4 million patients in the United States each year. Around 20% of these patients are admitted to hospitals for treatment. In patients requiring inpatient treatment, overall mortality is approximately 12%. However, it can be much higher in CAP patients requiring admission to the ICU. When parenteral antimicrobials are required for the treatment of hospitalized patients, the mainstay of therapy for many years has included either a combination of a β-lactam antibiotic with a macrolide antibiotic, or the use of a respiratory fluoroquinolone alone. β-lactam antibiotics do not have antibacterial activity against the so-called “atypical bacteria,” including species of Mycoplasma, Chlamydia, andLegionella, which are important pathogens in CAP. Classes of antibiotics active against these atypical pathogens include macrolides, fluoroquinolones, and tetracyclines. Urgent Need of New Antimicrobial Agents Two important realities are beginning to impact the traditional recommendations for antimicrobial therapy in CAP. First, there is an urgent need for the development of new antimicrobial agents that are more active against resistant bacterial pathogens. Second, the rapid development of antimicrobial-resistant bacterial pathogens has compromised many of our existing antimicrobials. “Antimicrobial resistance continues to increase in a dramatic fashion.” While there are many reasons for the slowing of new antimicrobial discoveries and the rapid development of antimicrobial resistance, the major factors appear to be overuse and misuse of antibiotics in both man and animals and the inability of the pharmaceutical industry to realize significant financial return on investment from new antimicrobial development. This lack of new agents has been called one of the three greatest threats to human health by the Infectious Diseases Society of America (IDSA). Yet, antimicrobial...
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