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Evidence for new treatments in CAP

As the aetiology of community-acquired pneumonia (CAP) continues to evolve, new antimicrobials have been approved for use in CAP therapy, both at the hospital and community levels. Several antimicrobials are being evaluated in Phase III clinical trials and their results allow their possible incorporation into the treatment of CAP. Other drugs being evaluated in preclinical phases may become available in the future.

When are antibiotics appropriate in ARS?

In North America, acute rhinosinusitis (ARS) is a major driver of antibiotic consumption. Prescribers are encouraged to revisit diagnostic criteria for acute bacterial rhinosinusitis (ABRS) when evaluating patients with ARS, to help identify those who require antibiotics, and prescribe the most appropriate antibiotic treatment.

Developing quality indicators to improve quality of care in ABRS

Quality indicators (QIs) are an initial step toward improving the quality of care provided to patients. Acute bacterial rhinosinusitis (ABRS), a complication of upper respiratory tract infections (URTIs), lacks specifi c QIs. This study proposes 7 ABRS specific QIs to evaluate the diagnosis and management that reduces symptoms, improves quality of life, and prevents complications.

Paediatric pneumonia: comparing β-lactams and macrolides

In many countries, inappropriate treatment for community-acquired pneumonia (CAP) is linked to increased mortality and morbidity. This paper reviews six studies comparing the efficacy of β-lactams with macrolides for treating CAP in the paediatric population. The majority concluded the use of macrolides as monotherapy or add-on therapy to β-lactams is more effective than β-lactams alone.

A Europe-wide appraisal of national guidelines for AOM

National guidelines for the management of acute otitis media (AOM) play a vital role in antibiotic stewardship (ABS). This review evaluates European guidelines for AOM in children based on methodological quality, Strength of Recommendations and consideration of ABS. While major similarities were found, the authors encourage development of centrally produced, locally adapted AOM guidelines to reduce unnecessary administration of antibiotics.

Can we improve management of CAP in children?

Community-acquired pneumonia (CAP) is still a leading cause of death among children aged under 5 years worldwide, with an estimate of 921,000 deaths in 2015. In a review of the latest literature for paediatric CAP, several danger signs are recognised as indicators for hospitalisation. While antibiotics are recommended as first-line treatment for CAP in children, further work is needed to distinguish bacterial from viral infections.

Management of CAP in the ICU

Mortality related to severe community-acquired pneumonia (SCAP) is a major concern, especially in older patients. Reviewing the risk factors, microbiology, site of care decisions and treatment of patients with SCAP highlighted the importance of timely, appropriate and adequate antibiotic coverage to decrease mortality and avoid drug resistance. Worse patient outcomes were associated with delay in ICU care and use of inappropriate antibiotics.

Evaluating Antibiotics commonly prescribed in paediatric CA-RTIs

Acute otitis media (AOM), acute bacterial rhinosinusitis (ABRS) and the lower respiratory tract infection, community-acquired pneumonia (CAP), are often treated with antibiotics. This paper evaluates the pharmacological properties of the preferred agents, amoxicillin and amoxicillin + clavulanic acid, compared with oral cephalosporins also prescribed in AOM, ABRS, and CAP. The analysis revealed that oral cephalosporins provide unnecessarily broad spectra of activity.


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