Fluoroquinolones in the Management of Community-acquired Pneumonia in Primary Care

Brian Wispelwey; Katherine R Schafer


Expert Rev Anti Infect Ther. 2010;8(11):1259-1271. 

In This Article

Community-acquired Pneumonia

The IDSA defines CAP as an acute infection of the pulmonary parenchyma associated with symptoms of pneumonia in a patient not hospitalized or residing in a long-term care facility for 14 days or more before the onset of symptoms.[19] By contrast, hospital-acquired pneumonia is pneumonia that occurs at least 48 h after hospital admission.[20] However, there are some patients in long-term care who develop pneumonia that is better managed in accordance with CAP guidelines because of the specific pathogens involved.[1] Furthermore, substantial overlap exists among the guidelines published by the IDSA and the ATS for the management of CAP and hospital-acquired pneumonia.[1]

Although CAP can affect individuals in any age group, both the incidence and mortality rate of this disease increase at age 65 years or older. Each year, more than 900,000 elderly patients in the USA develop CAP.[1,21] In those aged 85 years or older, the case rate per 1000 person-years is double the incidence in those aged 75–79 years and nearly three-times the rate that occurs in those aged 65–69 years.[21,22] The elderly also account for a disproportionate number of serious CAP cases – of 1.3 million patients discharged after hospital treatment for pneumonia in 2004, 60% were 65 years of age or older, and the average length of stay in this age group was 6.1 days, compared with 5.1 days for the overall population.[4,102] This disease also has a higher incidence and mortality rate in those with comorbidities.[2]


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