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Review
. 2023 May 31;91(3):224-238.
doi: 10.3390/arm91030018.

Identify Drug-Resistant Pathogens in Patients with Community-Acquired Pneumonia

Francesco Amati  1   2 , Francesco Bindo  2   3 , Anna Stainer  1   2 , Andrea Gramegna  3   4 , Marco Mantero  3   4 , Mattia Nigro  1   2 , Linda Bussini  1   5 , Michele Bartoletti  1   5 , Francesco Blasi  3   4 , Stefano Aliberti  1   2
Affiliations
Review

Identify Drug-Resistant Pathogens in Patients with Community-Acquired Pneumonia

Francesco Amati et al. Adv Respir Med. .

Abstract

A substantial increase in broad-spectrum antibiotics as empirical therapy in patients with community-acquired pneumonia (CAP) has occurred over the last 15 years. One of the driving factors leading to that has been some evidence showing an increased incidence of drug-resistant pathogens (DRP) in patients from a community with pneumonia, including methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Research has been published attempting to identify DRP in CAP through the implementation of probabilistic approaches in clinical practice. However, recent epidemiological data showed that the incidence of DRP in CAP varies significantly according to local ecology, healthcare systems and countries where the studies were performed. Several studies also questioned whether broad-spectrum antibiotic coverage might improve outcomes in CAP, as it is widely documented that broad-spectrum antibiotics overuse is associated with increased costs, length of hospital stay, drug adverse events and resistance. The aim of this review is to analyze the different approaches used to identify DRP in CAP patients as well as the outcomes and adverse events in patients undergoing broad-spectrum antibiotics.

Keywords: broad-spectrum antibiotics; community-acquired pneumonia; drug-resistant pathogens.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consequences of broad-spectrum antibiotic overuse. In red: negative impact on a single patient’s prognosis. In black: potentially harmful effects on public health.
Figure 2
Figure 2
Guidelines algorithm for DRP treatment [77].
See this image and copyright information in PMC

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