Optimal treatment strategies for community-acquired pneumonia: High-risk patients (geriatric and with comorbidity)

The four major factors predisposing individuals to community-acquired pneum onia (CAP) are chronic obstructive pulmonary disease, congestive heart fail ure, diabetes, and a high alcohol intake. The elderly are also at increased risk of severe infection. The introduction of fluoroquinolones with increa sed activity against Streptococcus pneumoniae and other CAP pathogens has b een an important development, with recent guidelines recommending the use o f respiratory fluoroquinolones as a first-line choice in outpatients with m odifying factors, nursing home residents, and hospitalised patients in medi cal wards. Of the fluoroquinolones currently available that have antipneumo coccal activity, levofloxacin is well tolerated and effective. It has been approved by the Food and Drug Administration (FDA) for treatment of CAP and widespread use has shown it to be very safe. Copyright (C) 2001 S. KargerA G, Basel.