J Am Acad Nurse Prac
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J Am Acad Nurse Prac · Apr 2004
ReviewAppropriate outpatient macrolide use in community-acquired pneumonia.
To review current guidelines concerning the outpatient management of community-acquired pneumonia (CAP), to discuss antibiotic resistance and its relation to outcomes, and to define the appropriate use of newer macrolides in CAP. ⋯ In an effort to improve outcomes, several guidelines have been published recommending appropriate antimicrobial agents to treat CAP in different patient populations. All guidelines base treatment recommendations on the hospitalization status of the patient, and all agree that coverage of atypical pathogens as part of an initial empirical regimen is important. Comorbidity and modifying factors that may increase the risk of infection with resistant organisms also are taken into account. Controversy exists regarding the use of newer macrolides versus newer fluoroquinolones as initial empirical therapy. The applicability of the reported increasing resistance of common pneumonia pathogens to outcomes in regimens containing newer macrolides is a subject of debate. Defining appropriate antimicrobial use in different patient groups should help achieve better outcomes and allay the development of resistance.