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

A blood culture test is performed before antibiotic administration for all patients with moderate or severe community-acquired pneumonia. S. pneumoniae is the most commonly detected causative bacteria of community-acquired pneumonia in blood culture tests. It has a high diagnostic value compared with other culture testes once the bacteria grow, and provides important information about antibiotic resistance. However, it has low bacterial detection rates of 5-14% for community-acquired pneumonia [75, 95] , and it has a limited influence on treatment even when positive results are obtained [74, 75] . In a systematic analysis using data of 3,898 patients with community-acquired pneumonia from 15 observational studies, blood culture results had almost no effect on the changes in the selection of empirical antibiotic, and even when they did, they did not significantly affect treatment outcomes [96] . However, since immunodeficient patients and other high-risk groups were excluded in this analysis, its results cannot be generalize d to moderate community-acquired pneumonia. There is an overlap between the predictors of blood culture positivity and the risk factors of severe community-acquired pneumonia [97] . For this reason, a blood culture test is indicated and must be performed for patients with severe community-acquired pneumonia. The test is also recommended for patients with immunodeficiency disorders such as alienia and complement deficiencies, chronic liver disease, and leukopenia [74] .