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Evidence-based medicine: empiric antibiotic therapy in community-acquired pneumonia

Evidence-based medicine: empiric antibiotic therapy in community-acquired pneumonia
Evidence-based medicine: empiric antibiotic therapy in community-acquired pneumonia

A number of national society guidelines exist for empiric management of community-acquired pneumonia but these are, to a large extent, not evidence-based, but based on clinical experience, in vitro data, pragmatism and common sense. Many randomized controlled trials of antibiotic therapy in community-acquired pneumonia have been conducted, but most of these have been powered to demonstrate equivalent efficacy of new treatments in comparison with conventional antimicrobial therapy. Development of new antibiotics has been driven by the emergence of penicillin-resistant Streptococcus pneumoniae, but so far there is no hard evidence that beta-lactam therapy fails in community-acquired pneumonia, at least with the higher doses of penicillins that are commonly used in hospital practice. Nonetheless, newer antibiotics have been deployed including macrolides and quinolones, and have demonstrated equivalent (and in some cases, marginally improved) efficacy to older antibiotic treatments in randomized control trials. A number of studies have shown that it is possible to stratify patients according to severity of illness, to in-patient or out-patient management protocols. These have been validated and refined.

Anti-Bacterial Agents, Community-Acquired Infections, Humans, Penicillin Resistance, Pneumonia, Bacterial, Practice Guidelines as Topic, Randomized Controlled Trials as Topic, Journal Article, Review
0163-4453
171-178
Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Read, R.C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51

Read, R.C. (1999) Evidence-based medicine: empiric antibiotic therapy in community-acquired pneumonia. Journal of Infection, 39 (3), 171-178.

Record type: Article

Abstract

A number of national society guidelines exist for empiric management of community-acquired pneumonia but these are, to a large extent, not evidence-based, but based on clinical experience, in vitro data, pragmatism and common sense. Many randomized controlled trials of antibiotic therapy in community-acquired pneumonia have been conducted, but most of these have been powered to demonstrate equivalent efficacy of new treatments in comparison with conventional antimicrobial therapy. Development of new antibiotics has been driven by the emergence of penicillin-resistant Streptococcus pneumoniae, but so far there is no hard evidence that beta-lactam therapy fails in community-acquired pneumonia, at least with the higher doses of penicillins that are commonly used in hospital practice. Nonetheless, newer antibiotics have been deployed including macrolides and quinolones, and have demonstrated equivalent (and in some cases, marginally improved) efficacy to older antibiotic treatments in randomized control trials. A number of studies have shown that it is possible to stratify patients according to severity of illness, to in-patient or out-patient management protocols. These have been validated and refined.

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More information

Published date: November 1999
Keywords: Anti-Bacterial Agents, Community-Acquired Infections, Humans, Penicillin Resistance, Pneumonia, Bacterial, Practice Guidelines as Topic, Randomized Controlled Trials as Topic, Journal Article, Review

Identifiers

Local EPrints ID: 417398
URI: http://eprints.soton.ac.uk/id/eprint/417398
ISSN: 0163-4453
PURE UUID: d5a5df38-2f52-4b46-9553-972a8d0536aa
ORCID for R.C. Read: ORCID iD orcid.org/0000-0002-4297-6728

Catalogue record

Date deposited: 30 Jan 2018 17:31
Last modified: 10 Nov 2021 03:30

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