Semin Respir Crit Care Med 2000; 21(1): 0033-0044
DOI: 10.1055/s-2000-9930
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Antibiotic Resistance in Community-Acquired Pulmonary Pathogens

Franco Paradisi, Giampaolo Corti
  • Infectious Disease Unit, University of Florence School of Medicine Careggi Hospital, Florence, Italy
Further Information

Publication History

Publication Date:
31 December 2000 (online)

 

ABSTRACT

Among infectious diseases, pneumonia is still the ``captain of the men of death.'' Etiologic diagnosis is often unreliable; consequently, clinicians must know epidemiology of community-acquired pneumonia for optimizing empiric antibiotic therapy. In recent years, all major pulmonary pathogens have become more and more resistant to conventional antibiotics. Penicillin-resistant and even multiresistant pneumococci have spread worldwide, but primarily in the United States, some European countries, South Africa, and the Far East. A similar trend is evidenced by ampicillin-resistant Hemophilus influenzae, whereas Moraxella catarrhalis almost invariably produces β-lactamases. The widening of methicillin-resistant Staphylococcus aureus from hospitals to the community may be the new reality of the 1990s. Increasing erythromycin resistance of Streptococcus pyogenes requires β-lactam therapy. The spread of both cromosomally and plasmid-mediated β-lactamases makes treatment of infections caused by gram-negative enterobacilli more difficult. Bacterial resistance creates a challenge for clinicians from the viewpoint of correct and successful management of patients with community-acquired pneumonia.

KEYWORD

Antibiotic resistance - community-acquired - lower respiratory tract infection