Abstract
Three cases of community-acquired pneumonia (CAP), requiring intensive care admission, are presented. The clinical picture of a "typical" bacterial pneumonia in the three patients led to an initial empirical treatment with amoxicillin clavulanic acid or 2(nd) generation cephalosporins. The treatment had to be changed in all three because of clinical failure. Erythromycin was added to the therapy with good clinical evolution. Serology confirmed atypical organisms to be responsible. Only the chest X-ray might have suggested an "atypical" or a "viral-like" agent. A proposition is made for an empirical combination of antibiotics in severely ill patients with CAP with more than unilobar consolidation.
MeSH terms
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Adult
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Amoxicillin / administration & dosage
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Amoxicillin / therapeutic use
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Amoxicillin-Potassium Clavulanate Combination
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / therapeutic use
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Cefuroxime / administration & dosage
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Cefuroxime / therapeutic use
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Cephalosporins / administration & dosage
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Cephalosporins / therapeutic use
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Clarithromycin / administration & dosage
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Clarithromycin / therapeutic use
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Clavulanic Acids / administration & dosage
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Clavulanic Acids / therapeutic use
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Community-Acquired Infections / diagnosis*
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Community-Acquired Infections / diagnostic imaging
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Critical Care
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Diagnosis, Differential
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Drug Therapy, Combination / administration & dosage
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Drug Therapy, Combination / therapeutic use
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Erythromycin / administration & dosage
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Erythromycin / therapeutic use
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Female
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Gentamicins / administration & dosage
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Gentamicins / therapeutic use
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Humans
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Male
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Middle Aged
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Netilmicin / administration & dosage
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Netilmicin / therapeutic use
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Pneumonia, Bacterial / diagnosis*
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Pneumonia, Bacterial / diagnostic imaging
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Pneumonia, Mycoplasma / diagnosis*
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Pneumonia, Mycoplasma / diagnostic imaging
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Psittacosis / diagnosis*
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Psittacosis / diagnostic imaging
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Radiography
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Treatment Failure
Substances
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Anti-Bacterial Agents
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Cephalosporins
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Clavulanic Acids
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Gentamicins
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Netilmicin
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Erythromycin
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Amoxicillin-Potassium Clavulanate Combination
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Amoxicillin
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Clarithromycin
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Cefuroxime