Community acquired respiratory tract infections. Effectivity and resistance of different antibiotics against relevant bacterial species

square Background:The American Thoracic Society: regards fluoroquinolones t ogether with macrolides and doxycyclin as first choice antibiotics in the e mpirical treatment of community acquired pneumoniae in non-hospitalized pat ients, while the Deutsche Gesellschaft fur Pneumologie only recommends macr olides and doxycyclin for these patients. square Material and Methods: In order to find out if the German recommendat ions stilt adequately reflect the local resistance situation! we analyzed a ntibiotic resistance of clinically relevant isolates of Streptococcus pneum oniae, Haemophilus influenzae and Moraxella catarrhalis in a multiceneter s tudy with special reference to sparfloxacin and ciprofloxacin according to DIN recommendations. square Results: In contrast to other European countries and the USA the pre valence of antibiotic resistance in Germany is low. Betalactam antibiotics were effective against more than 95% of strains of Haemophilus influenzae a nd Streptococcus pneumoniae. However, 10% of the strains of Streptococcus p neumoniae were resistant to tetracyclin and 7% resistant to erythromycin. R esistances against ciprofloxacin and sparfloxacin were not detectable. Of b oth quinolone antibiotics, sparfloxacin was always more active than ciprofl oxacin. square Conclusions: These susceptibility data and the known prevalence of o ther respiratory tract pathogens such as Chlamydia pneumoniae and Mycoplasm a pneumoniae which are sensitive to erythromycin and tetracyclin therefore support the recommendations of the Deutsche Gesellschaft fur Pneumologie. H owever, newer fluoroquinolones with increased activity against pneumococci may be a helpful alternative for patients with persistent and recurrent exa cerbations of respirator infections and patients with relevant underlying d iseases or relevant risk factors.