New treatment options for pneumonia

A wide variety of pathogens are implicated in community-acquired pneumonia. Etiology is rarely identifiable either before or after initiation of therapy; thus, empiric therapy is usually required in order to cover the spectrum of possible pathogens and address the possibility of resistance. In selecting antimicrobial therapy, the physician should consider both the severity of illness and patient characteristics, such as age, comorbidity, and site of acquisition of the infection. Guidelines were established in 1993 that categorize patients by these factors - as well as by the decision to treat on an inpatient or outpatient basis - and that suggest regimens accordingly. With increasing resistance and the recognition of more frequent infection with copathogens, the most recently developed antibiotics - the new fluoroquinolones - have a role to play in this schema.