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JAC Advance Access published online on October 10, 2009
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkp359
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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 article

Antibiotics for community-acquired pneumonia

Matthew Dryden1,*, Kieran Hand2, Peter Davey3 and on behalf of the BSAC Council{dagger}

1 Department of Microbiology and Communicable Disease, Royal Hampshire County Hospital, Winchester SO22 5DG, UK 2 Pharmacy Department, Southampton University Hospitals NHS Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK 3 Division of Clinical and Population Sciences and Education, Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF, Scotland, UK

* Corresponding author. Tel: +44-1962-824451; Fax: +44-1962-825431; E-mail: matthew.dryden{at}wehct.nhs.uk

Antibiotic guidelines for community-acquired pneumonia (CAP) often recommend broad-spectrum agents for severe pneumonia. While these may be entirely appropriate in terms of their spectrum of activity and efficacy, there is a risk that such recommendations could result in over-prescribing of broad-spectrum agents with consequent ‘collateral damage’, meaning superinfection by resistant pathogens, or selection of antibiotic resistance. Narrow-spectrum agents are often as effective and result in less collateral damage. National and local antibiotic guidance should promote choices of agents for narrow-spectrum prescribing even for severe CAP where appropriate.

Key Words: CAP , guidelines , prescribing , antibiotic policy , antibiotic stewardship , collateral damage

{dagger} Members are listed in the Acknowledgements.


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