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JAC Advance Access originally published online on September 9, 2009
Journal of Antimicrobial Chemotherapy 2009 64(5):889-894; doi:10.1093/jac/dkp313
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading articles

Swine flu and antibiotics

Gavin D. Barlow* on behalf of the BSAC Council

Department of Infection & Tropical Medicine, Castle Hill Hospital, Hull & East Yorkshire Hospitals NHS Trust, Cottingham, East Yorkshire HU16 5JQ, UK

* Tel: +44-01482-875875, ext. 2267; Fax: +44-01482-622494; E-mail: Gavin.Barlow{at}hey.nhs.uk

Health services worldwide are likely to be hard-pressed by swine flu-related illness in the months ahead. Secondary infections with Streptococcus pneumoniae, other streptococci (e.g. Streptococcus pyogenes), Haemophilus influenzae and Staphylococcus aureus are likely to be important causes of morbidity and mortality. The UK Department of Health recently published clinical pathways for the management of swine flu. Suggested severity criteria have not been validated in respiratory infection and are different from those previously published. Antibiotics are recommended for all patients assessed at hospital, regardless of severity of illness; cephalosporins or quinolones are suggested for inpatients with pneumonia. These recommendations will jeopardize recent decreases in Clostridium difficile-associated diarrhoea (CDAD) and methicillin-resistant S. aureus (MRSA) in UK hospitals. This article, written on behalf of the BSAC Council, considers these recommendations and provides alternative antibiotic regimens for a range of clinical scenarios.

Keywords: influenza , pneumonia , lower respiratory tract infections


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M. Eisenhut
Comment on: Swine flu and antibiotics
J. Antimicrob. Chemother., November 6, 2009; (2009) dkp415v1.
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