Appropriate antibiotic management of bacterial lower respiratory tract infections [version 1; peer review: 2 approved]

Lower respiratory tract infections are the leading cause of infectious disease deaths worldwide and are the fifth leading cause of death overall. This is despite conditions such as pneumococcal infections and influenza being largely preventable with the use of appropriate vaccines. The mainstay of t...

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Bibliographic Details
Published in:F1000 research 2018, Vol.7, p.1121
Main Authors: Feldman, Charles, Richards, Guy
Format: Article
Language:English
Subjects:
Antibiotic resistance
Antibiotics
Antimicrobial agents
Chronic obstructive pulmonary disease
Immunization
Infectious diseases
Influenza
Literature reviews
Lung diseases
Mortality
Obstructive lung disease
Respiratory tract diseases
Respiratory tract infection
Review
Systematic review
Vaccines
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Summary:Lower respiratory tract infections are the leading cause of infectious disease deaths worldwide and are the fifth leading cause of death overall. This is despite conditions such as pneumococcal infections and influenza being largely preventable with the use of appropriate vaccines. The mainstay of treatment for the most important bacterial lower respiratory tract infections, namely acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP), is the use of antibiotics. Yet despite a number of recent publications, including clinical studies as well as several systematic literature reviews and meta-analyses, there is considerable ongoing controversy as to what the most appropriate antibiotics are for the empiric therapy of CAP in the different settings (outpatient, inpatient, and intensive care unit). Furthermore, in the case of AECOPD, there is a need for consideration of which of these exacerbations actually need antibiotic treatment. This article describes these issues and makes suggestions for appropriately managing these conditions, in the setting of the need for antimicrobial stewardship initiatives designed to slow current emerging rates of antibiotic resistance, while improving patient outcomes.
ISSN:2046-1402
2046-1402
DOI:10.12688/f1000research.14226.1