Respiratory infections: established therapy and its limitations.

Factors influencing the selection of an antibiotic include the findings of susceptibility tests, the relative ability of various agents to reach the site of infection, and the difficulties of treating resistant microorganisms. After a brief review of these factors and the characteristics of piperacillin, established therapies for acute bronchitis, chronic bronchitis, bacterial pneumonias, pleurisy and empyema, bronchiectasis, lung abscess, and cystic fibrosis are outlined. New therapies for various lower respiratory tract infections, aspiration or decubitus pneumonia, and infections in patients with cystic fibrosis, and in immunocompromised patients are discussed, as are the advantages and disadvantages of aerosol administration or endotracheal instillation of antibiotics.