What new antibiotics to offer in the outpatient setting.

The treatment of community-acquired pneumonia is empiric. Guidelines have been developed to assist the clinician in selecting antibiotics to cover the likely pathogens. Given the difficulty of predicting an etiologic agent from patient characteristics, radiologic findings, and laboratory studies, initial regimens recommend broad-spectrum coverage. In some circumstances, two antibiotics may be required. The prevalence of resistant organisms is increasing and must be considered when prescribing treatment. Patient compliance is essential for successful therapy but diminishes with inconvenient dosing schedules and with poorly tolerated medicines. A number of novel antimicrobials have either been just launched or are in the late stages of development. Most have been developed in an attempt to address the above concerns. This article focuses on the new oral cephalosporins, macrolides, and fluoroquinolones, and discusses the place of each in the therapy of community-acquired pneumonia.