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

In a study that prospectively observed 288 inpatients with severe pneumonia, 56% of the patients showed clinical improvements at seven days, but only 25% radiologically showed improvements. At 28 days, 78% patients completely recovered based on clinical findings, but only 53% had complete lesion loss based on chest X-rays [198] . In a study that monitored chest X-rays of 81 patients with community-acquired pneumonia in emergency and outpatient departments for 24 weeks, 50.6% of the patients had complete lesion loss at two weeks, and only 66.7% had complete lesion loss at four weeks [199] . Radiological improvements were usually observed slowly in multilobar pneumonia, and the rate of improvement in chest X-rays changed depending on the patient's age and underlying lung diseases [199, 200] . Most patients who were 50 years old or younger, and had no underlying lung diseases show lesion improvement on chest X-rays within four weeks; however, patients who are 50 years or older, and have under-lying lung diseases may not show radiological improvements until after 12 weeks [200] . In addition, treatment outcome of pneumonia is not associated with signs of worsening on chest X-rays taken during a follow-up period [198] . Therefore, repeatedly taking chest X-rays from patients with pneumonia who have shown clinical improvements may not have any additional benefits.