J Korean Med Assoc.  2007 Oct;50(10):886-893. 10.5124/jkma.2007.50.10.886.

Treatment of Community-Acquired Pneumonia in Korea

Affiliations
  • 1Division of Infectious Diseases, Syunkyunkwan University School of Medicine, Korea. krpeck@skku.edu

Abstract

Community-acquired pneumonia (CAP) still remains one of the most important causes of morbidity and mortality. Improving the care of patients with CAP has been the focus of many different organizations, and several guidelines have been published in the United States and Europe. When the patients are treated according to the guidelines, there are beneficial effects in outcome. Empirical treatment should depend on the regional epidemiological information on the pathogen distribution and their antimicrobial resistance. Therefore, the guidelines from other countries could not be directly applied to the treatment of CAP in Korea. Inappropriate empirical treatment has been related with treatment failure. Therefore, physicians should be aware of the recent epidemiological data on antimicrobial resistance of the most common pathogens in order to choose the active agents against pneumococcus and atypical pathogens for the treatment of CAP.

Keyword

Community-acquired pneumonia; Treatment; Streptococcus pneumoniae; Atypical pneumonia

MeSH Terms

Europe
Humans
Korea*
Mortality
Pneumonia*
Streptococcus pneumoniae
Treatment Failure
United States

Reference

1. Almirall J, Bolibar I, Vidal J, Sauca G, Coll P, Niklasson B, Bartolome M, Balanzo X. Epidemiology of community acquired pneumonia in adults: a population-based study. Eur Respir J. 2000. 15:757–763.
Article
2. Gutierrez F, Masia M, Mirete C, Soldan B, Rodriguez JC, Padilla S, Hernandez I, Royo G, Martin-Hidalgo A. The influence of age and gender on the population-based incidence of community-acquired pneumonia caused by different microbial pathogens. J Infect. 2006. 53:166–174.
Article
3. Jokinen C, Heiskanen L, Juvonen H, Kallinen S, Kleemola M, Koskela M, Leinonen M, Ronnberg PR, Saikku P, Sten M, Tarkiainen A, Tukiainen H, Pyorala K, Makela PH. Microbial etiology of community-acquired pneumonia in the adult population of 4 municipalities in eastern Finland. Clin Infect Dis. 2001. 32:1141–1154.
Article
4. Kim MJ, Cheong HJ, Sohn JW, Shim HS, Park DW, Park SC, Woo JH, Kang JM, Kim YK, Shin WS, Kim YR, Lee HJ, Kim JH. A Prospective Multicenter Study of the Etiological Analysis in Adults with Community-Acquired Pneumonia: Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi. Korean J Infect Dis. 2001. 33:24–31.
5. Sohn JW, Park SC, Choi YH, Woo HJ, Cho YK, Lee JS, Sim HS, Kim MJ. Atypical pathogens as etiologic agents in hospitalized patients with community-acquired pneumonia in Korea: a prospective multi-center study. J Korean Med Sci. 2006. 21:602–607.
Article
6. Song JH, Jung SI, Ko KS, Kim NY, Son JS, Chang HH, Ki HK, Oh WS, Suh JY, Peck KR, Lee NY, Yang Y, Lu Q, Chongthaleong A, Chiu CH, Lalitha MK, Perera J, Yee TT, Kumarasinghe G, Jamal F, Kamarulzaman A, Parasakthi N, Van PH, Carlos C, So T, Ng TK, Shibl A. High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrob Agents Chemother. 2004. 48:2101–2107.
Article
7. Woo JH, Kang JM, Kim YS, Shin WS, Ryu JH, Choi JH, Kim YR, Cheong HJ, Uh ST, Park CS, Chung MH, Chung KS, Lee CJ, Ryu J. A Prospective Multicenter Study of Community-acquired Pneumonia in Adults with Emphasis on Bacterial Etiology. Korean J Infect Dis. 2001. 33:1–7.
8. Arancibia F, Ewig S, Martinez JA, Ruiz M, Bauer T, Marcos MA, Mensa J, Torres A. Antimicrobial treatment failures in patients with community-acquired pneumonia: causes and prognostic implications. Am J Respir Crit Care Med. 2000. 162:154–160.
Article
9. Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999. 115:462–474.
10. Roson B, Carratala J, Fernandez-Sabe N, Tubau F, Manresa F, Gudiol F. Causes and factors associated with early failure in hospitalized patients with community-acquired pneumonia. Arch Intern Med. 2004. 164:502–508.
Article
11. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM Jr, Musher DM, Niederman MS, Torres A, Whitney CG. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007. 44:S2. S27–S72.
Article
12. Choi KM, Yeon SI, Shin JS, Yong DE, Lee KW, Kim DS. Serotype and Antimicrobial Susceptibility of Streptococcus pneumoniae. Infect Chemother. 2006. 38:179–185.
13. Andes D, Craig WA. In vivo activities of amoxicillin and amoxicillin-clavulanate against Streptococcus pneumoniae: application to breakpoint determinations. Antimicrob Agents Chemother. 1998. 42:2375–2379.
Article
14. Piroth L, Martin L, Coulon A, Lequeu C, Duong M, Buisson M, Portier H, Chavanet P. Development of a new experimental model of penicillin-resistant Streptococcus pneumoniae pneumonia and amoxicillin treatment by reproducing human pharmacokinetics. Antimicrob Agents Chemother. 1999. 43:2484–2492.
Article
15. Kim IS, Ki CS, Kim S, Oh WS, Peck KR, Song JH, Lee K, Lee NY. Diversity of ampicillin resistance genes and antimicrobial susceptibility patterns in Haemophilus influenzae strains isolated in Korea. Antimicrob Agents Chemother. 2007. 51:453–460.
Article
16. Choo EJ, Kwak YG, Lee MS, Jeong JY, Choi SH, Kim NJ, Kim YS, Woo JH, Ryu J. In vitro Antimicrobial Activity of Cefcapene against Clinical Isolates. Infect Chemother. 2005. 37:133–137.
17. Song JY, Jo YM, Choi WS, Kee SY, Park CW, Hwang IS, Hyun JJ, Sohn JW, Lee CG, Cheong HJ, Kim WJ, Kim MJ. In Vitro Activity of Cefditoren against Respiratory Pathogens. Infect Chemother. 2005. 37:138–143.
18. Kwak YG, Choo EJ, Park SJ, Lee JE, Jeong JY, Choi SH, Kim NJ, Kim YS, Woo JH, Ryu J. In vitro antimicrobial activity of cefditoren against Streptococcus pneumoniae and Haemophilus influenzae clinical isolates. Korean J Med. 2007. 72:68–73.
19. Anderson KB, Tan JS, File TM Jr, DiPersio JR, Willey BM, Low DE. Emergence of levofloxacin-resistant pneumococci in immunocompromised adults after therapy for community-acquired pneumonia. Clin Infect Dis. 2003. 37:376–381.
Article
20. Doern GV, Richter SS, Miller A, Miller N, Rice C, Heilmann K, Beekmann S. Antimicrobial resistance among Streptococcus pneumoniae in the United States: have we begun to turn the corner on resistance to certain antimicrobial classes? Clin Infect Dis. 2005. 41:139–148.
Article
21. Ho PL, Tse WS, Tsang KW, Kwok TK, Ng TK, Cheng VC, Chan RM. Risk factors for acquisition of levofloxacin-resistant Streptococcus pneumoniae: a case-control study. Clin Infect Dis. 2001. 32:701–707.
Article
22. Chung MH, Shin WS, Kim YR, Kang MW, Kim MJ, Jung HJ, Park SC, Pai H, Choi HJ, Shin HS, Kim EC, Choe KW, Kim S, Peck KR, Song JH, Lee K, Kim JM, Chong Y, Han SW, Lee KM. Etiology of Community-Acquired Pneumonia Surveyed by 7 University Hospitals. Korean J Infect Dis. 1997. 29:339–359.
23. Dooley KE, Golub J, Goes FS, Merz WG, Sterling TR. Empiric treatment of community-acquired pneumonia with fluoroquinolones, and delays in the treatment of tuberculosis. Clin Infect Dis. 2002. 34:1607–1612.
Article
24. Wang JY, Hsueh PR, Jan IS, Lee LN, Liaw YS, Yang PC, Luh KT. Empirical treatment with a fluoroquinolone delays the treatment for tuberculosis and is associated with a poor prognosis in endemic areas. Thorax. 2006. 61:903–908.
Article
25. Yoon YS, Lee HJ, Yoon HI, Yoo CG, Kim YW, Han SK, Shim YS, Yim JJ. Impact of fluoroquinolones on the diagnosis of pulmonary tuberculosis initially treated as bacterial pneumonia. Int J Tuberc Lung Dis. 2005. 9:1215–1219.
26. Heffelfinger JD, Dowell SF, Jorgensen JH, Klugman KP, Mabry LR, Musher DM, Plouffe JF, Rakowsky A, Schuchat A, Whitney CG. Management of community-acquired pneumonia in the era of pneumococcal resistance: a report from the Drug-Resistant Streptococcus pneumoniae Therapeutic Working Group. Arch Intern Med. 2000. 160:1399–1408.
Article
27. Hagberg L, Carbon C, van Rensburg DJ, Fogarty C, Dunbar L, Pullman J. Telithromycin in the treatment of community-acquired pneumonia: a pooled analysis. Respir Med. 2003. 97:625–633.
Article
28. Pullman J, Champlin J, Vrooman PS Jr. Efficacy and tolerability of once-daily oral therapy with telithromycin compared with trovafloxacin for the treatment of community-acquired pneumonia in adults. Int J Clin Pract. 2003. 57:377–384.
29. Tellier G, Niederman MS, Nusrat R, Patel M, Lavin B. Clinical and bacteriological efficacy and safety of 5 and 7 day regimens of telithromycin once daily compared with a 10 day regimen of clarithromycin twice daily in patients with mild to moderate community-acquired pneumonia. J Antimicrob Chemother. 2004. 54:515–523.
Article
30. Clay KD, Hanson JS, Pope SD, Rissmiller RW, Purdum PP 3rd, Banks PM. Brief communication: severe hepatotoxicity of telithromycin: three case reports and literature review. Ann Intern Med. 2006. 144:415–420.
Article
31. Brown RB, Iannini P, Gross P, Kunkel M. Impact of initial antibiotic choice on clinical outcomes in community-acquired pneumonia: analysis of a hospital claims-made database. Chest. 2003. 123:1503–1511.
Article
32. Gleason PP, Meehan TP, Fine JM, Galusha DH, Fine MJ. Associations between initial antimicrobial therapy and medical outcomes for hospitalized elderly patients with pneumonia. Arch Intern Med. 1999. 159:2562–2572.
Article
33. Kolditz M, Halank M, Hoffken G. Monotherapy versus Combination Therapy in Patients Hospitalized with Community-Acquired Pneumonia. Treat Respir Med. 2006. 5:371–383.
Article
34. Paul M, Silbiger I, Grozinsky S, Soares-Weiser K, Leibovici L. Beta lactam antibiotic monotherapy versus beta lactam-aminoglycoside antibiotic combination therapy for sepsis. Cochrane Database Syst Rev. 2006. CD003344.
Article
35. Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC, Oh MD, Choe KW. Bloodstream infections caused by antibiotic-resistant gram-negative bacilli: risk factors for mortality and impact of inappropriate initial antimicrobial therapy on outcome. Antimicrob Agents Chemother. 2005. 49:760–766.
Article
36. Halm EA, Fine MJ, Marrie TJ, Coley CM, Kapoor WN, Obrosky DS, Singer DE. Time to clinical stability in patients hospitalized with community-acquired pneumonia: implications for practice guidelines. Jama. 1998. 279:1452–1457.
Article
37. Jay SJ, Johanson WG Jr, Pierce AK. The radiographic resolution of Streptococcus pneumoniae pneumonia. N Engl J Med. 1975. 293:798–801.
Article
38. Mittl RL Jr, Schwab RJ, Duchin JS, Goin JE, Albeida SM, Miller WT. Radiographic resolution of community-acquired pneumonia. Am J Respir Crit Care Med. 1994. 149:630–635.
Article
39. Dunbar LM, Wunderink RG, Habib MP, Smith LG, Tennenberg AM, Khashab MM, Wiesinger BA, Xiang JX, Zadeikis N, Kahn JB. High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm. Clin Infect Dis. 2003. 37:752–760.
Article
40. Chastre J, Wolff M, Fagon JY, Chevret S, Thomas F, Wermert D, Clementi E, Gonzalez J, Jusserand D, Asfar P, Perrin D, Fieux F, Aubas S. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. Jama. 2003. 290:2588–2598.
Article
41. Song JH, Jung SI, Ki HK, Shin MH, Ko KS, Son JS, Chang HH, Kim SW, Lee H, Kim YS, Oh WS, Peck KR, Chongthaleong A, Lalitha MK, Perera J, Yee TT, Jamal F, Kamarulzaman A, Carlos CC, So T. Clinical outcomes of pneumococcal pneumonia caused by antibiotic-resistant strains in asian countries: a study by the Asian Network for Surveillance of Resistant Pathogens. Clin Infect Dis. 2004. 38:1570–1578.
Article
42. Feikin DR, Schuchat A, Kolczak M, Barrett NL, Harrison LH, Lefkowitz L, McGeer A, Farley MM, Vugia DJ, Lexau C, Stefonek KR, Patterson JE, Jorgensen JH. Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997. Am J Public Health. 2000. 90:223–229.
Article
43. Waterer GW, Buckingham SC, Kessler LA, Quasney MW, Wunderink RG. Decreasing beta-lactam resistance in Pneumococci from the Memphis region: analysis of 2,152 isolates From 1996 to 2001. Chest. 2003. 124:519–525.
Article
44. Capelastegui A, Espana PP, Quintana JM, Gorordo I, Ortega M, Idoiaga I, Bilbao A. Improvement of process-of-care and outcomes after implementing a guideline for the management of community-acquired pneumonia: a controlled before-and-after design study. Clin Infect Dis. 2004. 39:955–963.
Article
45. Dean NC, Silver MP, Bateman KA, James B, Hadlock CJ, Hale D. Decreased mortality after implementation of a treatment guideline for community-acquired pneumonia. Am J Med. 2001. 110:451–457.
Article
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr