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
