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Báo cáo khoa học: "Choosing the right combination therapy in severe community-acquired pneumonia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Choosing the right combination therapy in severe community-acquired pneumonia. | Available online http ccforum.eom content 10 1 115 Commentary Choosing the right combination therapy in severe community-acquired pneumonia Grant W Waterer1 and Jordi Rello2 Associate Professor of Medicine School of Medicine and Pharmacology University of Western Australia MRF Building Royal Perth Hospital GPO Box X2213 Perth 6847 Australia 2Chief and Professor of Medicine Critical Care Department Joan XXIII University Hospital.Carrer Dr. Mallafre Guasch 4.43007 Tarragona Spain Corresponding author Grant W Waterer waterer@cyllene.uwa.edu.au Published 24 January 2006 This article is online at http ccforum.com content 10 1 115 2006 BioMed Central Ltd Critical Care 2006 10 115 doi 10.1186 cc3976 See related research by Mortensen et al. in this issue http ccforum.com content 10 1 R8 Abstract Recent studies have suggested that combination antibiotic therapy is preferable to monotherapy for severe community-acquired pneumonia CAP . In this issue Mortensen and colleagues present retrospective data suggesting that combination therapy with a cephalosporin and a fluoroquinolone is inferior to combination therapy with a cephalosporin and a macrolide. Several mechanisms exist by which quinolones could be inferior to macrolides in combination therapy so if these findings are confirmed by other groups they have significant implications for physicians treating patients with severe CAP. In the past 5 years there has been a substantial shift in thinking regarding the optimal therapy of patients with severe community-acquired pneumonia CAP particularly with respect to pneumococcal disease. Observational studies by Mufson and Stanek 1 Waterer et al. 2 Martinez et al. 3 Baddour et al. 4 and Weiss et al. 5 have all identified significant mortality reductions in patients with bacteraemic pneumococcal pneumonia who received combination antibiotic therapy in comparison with patients who received monotherapy. Additional observational studies in more general CAP cohorts have also identified