Treatment of community-acquired pneumonia in hospitalised patients

Community-acquired pneumonia (CAP) can be life-threatening. The prognosis i s generally poorest in elderly patients and/or those with underlying chroni c conditions, but fatalities can occur in all age groups. Current challenge s in the clinical management of CAP are discussed, and the criteria for ide ntifying those patients who should be treated in hospital with initial intr avenous therapy are considered. Rapid initiation of therapy is important, u sing an agent that provides coverage against the most likely pathogens-Stre ptococcus pneumoniae and the atypical organisms. There is an increasing ten dency to minimise the duration of intravenous therapy, with an early transi tion to oral therapy and the rapid return of the patient to the community. The efficacy of oral macrolides in the treatment of CAP is well established . Evidence for the use of intravenous azithromycin to provide effective and well-tolerated, first-line intervention in the hospitalized CAP patient is summarised. (C) 2001 Elsevier Science B.V. and International Society of Ch emotherapy. All rights reserved.