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

Therefore, the present revised guideline on the treatment of community-acquired pneumonia in Korea recommends the administration of β-lactam or respiratory fluoroquinolone alone for patients with mild-moderate pneumonia who are hospitalized in general wards. In addition, considering inpatients' characteristics, the guideline recommends intravenous injections of β-lactams including amoxicillin/clavulanic acid, ampicillin/sulbactam, cefotaxime, and ceftriaxone, or respiratory fluoroquinolones including gemifloxacin, levofloxacin, and moxifloxacin over oral antibiotics [expert opinion] [143, 144] . Combined administration of β-lactams and macrolides is recommended for treating atypical bacterial infections (Mycoplasma spp., Chlamydophila spp., Legionella spp.), for Lee MS, et al. Guideline for Antibiotic Use in Adults with Community-acquired Pneumonia www.icjournal.org 178 which the antibiotics have been reported to reduce the mortality rates of the infections, and for treating severe pneumonia [143, 144] . Oral macrolides must be used with care as they are associated with increased cardiovascular risks in patients of advanced age. These antibiotics are not recommended as there have been reports of low oral bioavailability of erythromycin, increased QT interval, and increased cardiovascular risks associated with macrolides [145, 146] .