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Traditional Antibiotics for Pneumonia Can Delay Emergence of Resistant Strains MELBOURNE, Australia -- August 26, 2008 -- Australian hospitals should avoid prescribing expensive, broad-spectrum antibiotics for pneumonia to prevent the development of more drug-resistant super bugs, according to a study published in the August issue of Clinical Infectious Diseases. The study showed that only 5% of people admitted to the hospital with community-acquired pneumonia had infections caused by organisms that could not be successfully treated with penicillin combined with an atypical antibiotic such as doxycycline or erythromycin. Patrick Charles, PhD, Austin Health, Heidelberg, Australia, and colleagues studied 885 people admitted to 6 Australian hospitals over 28 months from 2004 to 2006. Samples of blood, urine, sputum, and viral swabs of the nose and throat were analysed. Results showed that most cases of pneumonia were caused by easy-to-treat bacteria such as the pneumococcus or Mycoplasma, or alternatively by respiratory viruses that do not require antibiotic therapy. Only 5% of cases were caused by organisms that would require more expensive and broad-spectrum antibiotics. These cases were nearly all in patients who had frequent hospital admissions or were residents of nursing homes. "The study results show that current Australian guidelines for prescribing antibiotics for pneumonia are appropriate," said Dr. Charles. "It shows that Australian doctors should resist the push which is occurring in some parts of the world -- particularly the US -- to prescribe broad-spectrum antibiotics to treat essentially all possible causes." Dr. Charles said the trend toward broad-spectrum antibiotics was being driven by laboratory-based studies of resistance rates in bacteria sent to the labs rather than clinical studies of patients with pneumonia. In the laboratory-based studies, the bacterial isolates often come from highly selected patients with more difficult-to-treat disease. However, the more frequently these broad-spectrum antibiotics were used, the more likely it was that bacteria would be become resistant to them. "The emergence of antibiotic-resistant bacterial pathogens is one of the biggest threats to Australian healthcare standards and is closely linked to the inappropriate use of antibiotics," Dr. Charles said. "By continuing to use more traditional antibiotics to treat most cases of pneumonia, Australian doctors can limit or delay the emergence of more resistant strains of bacteria," he said, "and prolong the effective lifespan of these drugs." SOURCE: University of Melbourne E-mail this page to a friend or colleague! To print, use this version