Korean J Med.  2011 Dec;81(6):690-698.

Antibiotic Resistance and Treatment Update of Community-Acquired Pneumonia

• Kim SW

Abstract

The emergence of penicillin-resistant S. pneumoniae has issued in the management of community-acquired pneumonia (CAP). However, the clinical outcome did not match with penicillin resistance. Thus, recent (Jan/2008) change of penicillin breakpoints for nonmeningeal strain was done and this made prevalence of penicillin resistance under 5% worldwide. Macrolide resistance of S. pneumoniae in Korea is prevalent (70-80%). Thus, the Korean CAP guideline did not include macrolide monotherapy as empiric therapy. Fluoroquinolone resistance of pneumococcus is very low, however, concerning of the increase of resistance is present.Some new antibiotics for the multidrug resistant S. pneumoniae should be reserved for the future. Macrolide resistance of Mycoplasma pneumoniae is reported in various regions in the world, however, data of the clinical significance is rare. Increased beta-lactamase production of Haemophilus influenzae urges us to use beta-lactam/beta-lactamase or 3rd generation cephalosporin if Haemophilus is pathogen. Pneumococcal vaccine usage is an effective way to prevent invasive diseases by S. pneumoniae (including resistant pathogen). The rate of pneumococcal vaccination in Korea is very low (0.8% in adult). Strategies to control resistance that include effective antimicrobial treatment, vaccination, infection control, appropriate policies and regulations, 'antibiotic stewardship' and education of appropriate antibiotic use, are greatly in need.

Keyword

Pneumonia; Bacterial drug resistance; Antibiotic treatment

MeSH Terms

Anti-Bacterial Agents
beta-Lactamases
Drug Resistance, Microbial
Haemophilus
Haemophilus influenzae
Infection Control
Korea
Mycoplasma pneumoniae
Penicillin Resistance
Penicillins
Pneumonia
Pneumonia, Mycoplasma
Prevalence
Social Control, Formal
Sprains and Strains
Streptococcus pneumoniae
Vaccination
Anti-Bacterial Agents
Penicillins
beta-Lactamases