Guideline for Antibiotic Use in Adults with Community-acquired Pneumonia

Lee, Mi Suk; Oh, Jee Youn; Kang, Cheol-In; Kim, Eu Suk; Park, Sunghoon; Rhee, Chin Kook; Jung, Ji Ye; Jo, Kyung-Wook; Heo, Eun Young; Park, Dong-Ah; Suh, Gee Young; Kiem, Sungmin

The risk factors of P. aeruginosa infection include alcohol consumption, structural lung diseases such as bronchodilation, frequent use of steroids due to acute worsening of chronic obstructive pulmonary disease, and use of antibiotics in the last three months. If there is a possibility that a patient has pneumonia caused by P. aeruginosa, antibiotics that are effective against and highly sensitive to S. pneumoniae must be selected. Examples of these antibiotics include cefepime, piperacillin/tazobactam, imipenem, and meropenem. In a prospective observational study, gram-negative bacillus infections including those caused by P. aeruginosa were associated with high mortality rates [180] . In a multi-institutional study conducted in Asian, gram-negative bacilli accounted for 10.1% of all cases of deaths, were the most common causative bacteria of severe pneumonia, and were a risk factor of death [181] . Of these bacteria, P. aeruginosa may exhibit various levels of antibiotic resistance. Therefore, more than two empirical combination therapies are needed against these bacteria, and it is recommended to readjust the antibiotic selection once the bacteria are isolated and their susceptibility results are obtained [180] .