Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy.
Respiratory Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
Adv Respir Med. 2023 May 31;91(3):224-238. doi: 10.3390/arm91030018.
A substantial increase in broad-spectrum antibiotics as empirical therapy in patients with community-acquired pneumonia (CAP) has occurred over the last 15 years. One of the driving factors leading to that has been some evidence showing an increased incidence of drug-resistant pathogens (DRP) in patients from a community with pneumonia, including methicillin-resistant (MRSA) and . Research has been published attempting to identify DRP in CAP through the implementation of probabilistic approaches in clinical practice. However, recent epidemiological data showed that the incidence of DRP in CAP varies significantly according to local ecology, healthcare systems and countries where the studies were performed. Several studies also questioned whether broad-spectrum antibiotic coverage might improve outcomes in CAP, as it is widely documented that broad-spectrum antibiotics overuse is associated with increased costs, length of hospital stay, drug adverse events and resistance. The aim of this review is to analyze the different approaches used to identify DRP in CAP patients as well as the outcomes and adverse events in patients undergoing broad-spectrum antibiotics.
在过去的 15 年中，广谱抗生素作为经验性治疗社区获得性肺炎（CAP）患者的方法大量增加。导致这种情况的一个驱动因素是一些证据表明，来自肺炎社区的患者中耐药病原体（DRP）的发生率增加，包括耐甲氧西林金黄色葡萄球菌（MRSA）和。已经发表了一些研究，试图通过在临床实践中实施概率方法来确定 CAP 中的 DRP。然而，最近的流行病学数据显示，CAP 中 DRP 的发生率根据当地生态、医疗保健系统和进行研究的国家而有很大差异。一些研究还质疑广谱抗生素覆盖是否可以改善 CAP 的结果，因为广泛记录表明，广谱抗生素过度使用与成本增加、住院时间延长、药物不良反应和耐药性有关。本综述的目的是分析用于确定 CAP 患者中 DRP 的不同方法，以及接受广谱抗生素治疗的患者的结果和不良事件。
