October 8, 2021

New antibiotics may be useful as a treatment for community-acquired pneumonia

According to the study, lefamulin has antimicrobial activity against common pathogens that cause community-acquired bacterial pneumonia (CAP), but can also be used to treat atypical pathogens. Omadacycline has been approved for the treatment of CAP, as well as for acute bacterial infections of the skin and skin structures.

Ceftaroline interferes with the cell wall and controls most pathogens of CAP; whereas delafloxacin has been approved for the treatment of several causes of CAP and is compared to moxifloxacin.

Antimicrobials are frequently used to treat CAP, including azithromycin, Augmentin (amoxicillin / clavulanic acid), levofloxacin, and third generation cephalosporins. However, increased resistance to antibiotic treatments, caused by bacterial genetic mutations or the acquisition of drug resistance genes due to overuse of antibiotics, posed a problem, according to the study.

Streptococcus pneumoniae is the main bacteria responsible for CAP, however, atypical bacteria, such as Mycoplasma pneumoniae and Chlamydia pneumonia, could become more common, according to the study.

Streptococcus pneumoniae has been reported to be resistant to one or more antibiotics during treatment in about a third of cases. It is primarily resistant to macrolides, such as azithromycin. According to the report, Streptococcus pneumoniae is moderately sensitive to azithromycin 3.4%, erythromycin 1.9%, tetracycline 8.8% and penicillin 15.7%.

Streptococcus pneumoniae is sensitive to vancomycin, ceftaroline and levofloxacin.

People who are elderly or who have co-morbidities are more likely to be infected with CAP, according to the study.

ESCAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species), pathogens, which also cause CAP, show resistance to macrolides, fluoroquinolones, β-lactams, and third and fourth generation cephalosporins.

Staphylococcus aureus, a typical pathogen of ESKAPE, is sensitive to erythromycin 18%, ciprofloxacin 28% and levofloxacin 23.4%.

Atypical bacteria have a high level of resistance to macrolides. According to the study, fluoroquinolones or tetracyclines should be considered as alternatives.

The current treatment guide varies, but it is widely suggested that treatment is based on the presence or absence of an underlying disease and the severity of the CAP.

The Infectious Diseases Society of America / American Thoracic Society recommends that the first line of treatment for Streptococcus pneumoniae for people without comorbidities is amoxicillin or doxycycline.

For people with chronic illnesses, levofloxacin, moxifloxacin or a combination of -lactamins and macrolides are recommended.

Out of 100,000 adult people in the United States, 5,832 people with chronic obstructive pulmonary disease have contracted CAP. Other co-morbidities include, but are not limited to, asthma, bronchiectasis, coronary artery disease, and heart failure.

These people are also more likely to experience more complications and death.

In the United States, nearly 50% of people with CAP who are hospitalized are over 75 years old.

CAP can cause fever, cough, sputum, chest pain, and dyspnea. About 68% of adults with CAP are admitted to hospital, investigators said.

Reference

Shen L, Wang L, Lui C, Shi S, Takahashi T, Wang T. Community-acquired pneumonia: trends and research on drug resistance and advances in new antibiotics. Biosci trends. 2021; doi: 10.5582 / bst.2021.01342


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