Treatment of community-acquired pneumonia

Lee, Young R.; Houngue, Coovi; Hall, Ronald G.

doi:10.1586/14787210.2015.1060125

Cited by 5 publications

(2 citation statements)

References 97 publications

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“… 88 In cases of non-severe infection, in which oral monotherapy is a choice, cefuroxime and ampicillin-sulbactam have been safe options in regions with low resistance to β-lactams, as have fluoroquinolones, since pneumococci are rarely resistant. 89 In cases of CA-MRSA infection, the objective is to suppress toxin production, and the treatment of choice is clindamycin, trimethoprim/sulfamethoxazole, or linezolid. The potential for inducible clindamycin resistance in high-inoculum infections via efflux or ribosomal alterations should be taken into account.…”

Section: Recommendations For Pathogen-specific Targeted Therapy In Pmentioning

confidence: 99%

2018 recommendations for the management of community acquired pneumonia

et al. 2018

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Community-acquired pneumonia (CAP) is the leading cause of death worldwide. Despite the vast diversity of respiratory microbiota, Streptococcus pneumoniae remains the most prevalent pathogen among etiologic agents. Despite the significant decrease in the mortality rates for lower respiratory tract infections in recent decades, CAP ranks third as a cause of death in Brazil. Since the latest Guidelines on CAP from the Sociedade Brasileira de Pneumologia e Tisiologia (SBPT, Brazilian Thoracic Association) were published (2009), there have been major advances in the application of imaging tests, in etiologic investigation, in risk stratification at admission and prognostic score stratification, in the use of biomarkers, and in the recommendations for antibiotic therapy (and its duration) and prevention through vaccination. To review these topics, the SBPT Committee on Respiratory Infections summoned 13 members with recognized experience in CAP in Brazil who identified issues relevant to clinical practice that require updates given the publication of new epidemiological and scientific evidence. Twelve topics concerning diagnostic, prognostic, therapeutic, and preventive issues were developed. The topics were divided among the authors, who conducted a nonsystematic review of the literature, but giving priority to major publications in the specific areas, including original articles, review articles, and systematic reviews. All authors had the opportunity to review and comment on all questions, producing a single final document that was approved by consensus.

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Section: Recommendations For Pathogen-specific Targeted Therapy In Pmentioning

confidence: 99%

2018 recommendations for the management of community acquired pneumonia

et al. 2018

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“…For these reasons, initial antibiotic therapy in CAP remains mainly empirical [128]. The adjunction of "atypical" coverage has been a matter of debate, and this appellation may be misleading [129][130][131]. Indeed, benefits of combination of antibiotics (beta-lactams and macrolides for example) might encompass effective treatment of atypical pathogens, synergistic or adjunctive effect on typical pathogens or intrinsic properties of the drug (e.g., anti-inflammatory activity of macrolides) [27].…”

Section: Evidence Regarding Empiric Coverage Of Atypical Pathogensmentioning

confidence: 99%

Atypical Pathogens in Adult Community-Acquired Pneumonia and Implications for Empiric Antibiotic Treatment: A Narrative Review

et al. 2022

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Atypical pathogens are intracellular bacteria causing community-acquired pneumonia (CAP) in a significant minority of patients. Legionella spp., Chlamydia pneumoniae and psittaci, Mycoplasma pneumoniae, and Coxiella burnetii are commonly included in this category. M. pneumoniae is present in 5–8% of CAP, being the second most frequent pathogen after Streptococcus pneumoniae. Legionella pneumophila is found in 3–5% of inpatients. Chlamydia spp. and Coxiella burnetii are present in less than 1% of patients. Legionella longbeachae is relatively frequent in New Zealand and Australia and might also be present in other parts of the world. Uncertainty remains on the prevalence of atypical pathogens, due to limitations in diagnostic means and methodological issues in epidemiological studies. Despite differences between CAP caused by typical and atypical pathogens, the clinical presentation alone does not allow accurate discrimination. Hence, antibiotics active against atypical pathogens (macrolides, tetracyclines and fluoroquinolones) should be included in the empiric antibiotic treatment of all patients with severe CAP. For patients with milder disease, evidence is lacking and recommendations differ between guidelines. Use of clinical prediction rules to identify patients most likely to be infected with atypical pathogens, and strategies of narrowing the antibiotic spectrum according to initial microbiologic investigations, should be the focus of future investigations.

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Effects of Aib residues insertion on the structural–functional properties of the frog skin-derived peptide esculentin-1a(1–21)NH2

Biondi¹,

Casciaro

Grazia

et al. 2016

Amino Acids

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Antimicrobial peptides (AMPs) play a key role in the defence mechanism of living organisms against microbial pathogens, displaying both bactericidal and immunomodulatory properties. They are considered as a promising alternative to the conventional antibiotics towards which bacteria are becoming highly resistant. Recently, a derivative of the frog skin AMP esculentin-1a, esculentin-1a(1-21)NH [Esc(1-21)], showed a strong and fast membranolytic activity against Gram-negative bacteria but with a lower efficacy against Gram-positive ones. Here, with the aim to increase the α-helicity of Esc(1-21) and the expected potency against Gram-positive bacteria, we designed an analog bearing three α-aminoisobutyric acid (Aib) residues at positions 1, 10, and 18 of its primary structure. We demonstrated that the incorporation of Aib residues: (1) promoted the α-helix conformation of Esc(1-21), as confirmed by circular dichroism and two-dimensional nuclear magnetic resonance spectroscopies; (2) was sufficient to make this analog more active than the parent peptide against several Gram-positive bacterial strains without affecting its activity against Gram-negative bacteria; and (3) resulted to be devoid of toxic effect toward epithelial cells at the active antimicrobial concentrations. These results suggest that replacement of L-amino acids with Aib residues has beneficial effects on the structure and properties of the membrane-active peptide Esc(1-21), making it a better candidate for the design and development of selective drugs against Gram-positive bacteria.

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Treatment of community-acquired pneumonia

Cited by 5 publications

References 97 publications

2018 recommendations for the management of community acquired pneumonia

2018 recommendations for the management of community acquired pneumonia

Atypical Pathogens in Adult Community-Acquired Pneumonia and Implications for Empiric Antibiotic Treatment: A Narrative Review

Effects of Aib residues insertion on the structural–functional properties of the frog skin-derived peptide esculentin-1a(1–21)NH2

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