Approaches to treatment of community-acquired pneumonia in the emergency department and the appropriate role of fluoroquinolones

J Emerg Med. 2006 May;30(4):377-87. doi: 10.1016/j.jemermed.2005.07.009.

Abstract

The Emergency Department is a critical point of care for patients presenting with signs and symptoms of community-acquired pneumonia (CAP). The initial diagnosis, the decision to admit or discharge, the timing of initiating treatment, and appropriateness of the empirical therapy are key factors in successful management. Rising resistance rates to commonly used CAP antibiotics has complicated empirical treatment. Respiratory fluoroquinolones represent an important therapeutic option for patients with co-morbidities and risk factors for penicillin-, macrolide-, and multi-drug-resistant S. pneumoniae infections. Ensuring appropriate use is required to maintain their high level of effectiveness in key respiratory pathogens. Treatment guidelines from the Infectious Diseases Society of America, American Thoracic Society, and Centers for Disease Control and Prevention are available to assist emergency physicians in developing clinical pathways to ensure appropriate use of available therapies.

MeSH terms

  • Algorithms
  • Ambulatory Care
  • Anti-Bacterial Agents / economics
  • Anti-Bacterial Agents / therapeutic use*
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Drug Resistance, Bacterial
  • Emergency Service, Hospital
  • Female
  • Fluoroquinolones / economics
  • Fluoroquinolones / therapeutic use*
  • Humans
  • Intensive Care Units
  • Male
  • Patient Admission
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / economics
  • Practice Guidelines as Topic
  • Risk Assessment

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones