Antibiotic Treatment Strategies for Community-Acquired Pneumonia in Adults

There is limited evidence comparing different antibiotic treatment strategies for patients with clinically suspected community acquired pneumonia patients who are admitted to non-intensive care beds.

A study of 2283 patients in the Netherlands has compared treatment outcomes between patients treated with beta-lactam monotherapy, beta-lactam-macrolide combination therapy and fluroquinolone monotherapy.

In this study beta-lactam monotherapy was found to be non-inferior to other treatment strategies with regard to 90 day mortality.

Read more in the New England Journal of Medicine


  1. neil2513 · · Reply

    I could not find which antibiotics they were referring to
    (did mention at beginning of paper the previous antibiotics
    But could not find out which beta-lactam or macrolide of fluoroquinolone they were using)
    Am I just missing this data


    1. Hi Neil,
      The antibiotics used were based on the local guidelines and are listed in Table 1 under intervention strategies.


  2. Further comments on this paper available at

    Of note:
    As the authors acknowledge, the number of trial participants with Legionella pneumophila or other atypical pathogens was extremely low, and thus these findings are not applicable in all regions. Still, this “real-world” study suggests that for many non-ICU patients with suspected CAP, use of broader-spectrum antimicrobial treatment regimens is unwarranted. With today’s concerns regarding increasing resistance to fluoroquinolones and macrolides as well as the overuse of antibiotics, it is reasonable to question the appropriateness of continuing to have as a national quality measure for hospitals the proportion of CAP patients who are treated with the antibiotic regimens currently recommended in guidelines.


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