The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Antibiotic Resistance and Treatment Update of Community-Acquired Pneumonia

지역사회획득 폐렴에서의 항생제 내성 및 최신 치료

  • Kim, Shin-Woo (Department of Internal Medicine, Kyungpook National University School of Medicine)
  • 김신우 (경북대학교 의학전문대학원 내과학교실)
  • Published : 2011.12.01
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Abstract

The emergence of penicillin-resistant S. pneumoniae has issued in the management of community-acquired pneumonia (CAP). However, the clinical outcome did not match with penicillin resistance. Thus, recent (Jan/2008) change of penicillin breakpoints for nonmeningeal strain was done and this made prevalence of penicillin resistance under 5% worldwide. Macrolide resistance of S. pneumoniae in Korea is prevalent (70-80%). Thus, the Korean CAP guideline did not include macrolide monotherapy as empiric therapy. Fluoroquinolone resistance of pneumococcus is very low, however, concerning of the increase of resistance is present. Some new antibiotics for the multidrug resistant S. pneumoniae should be reserved for the future. Macrolide resistance of Mycoplasma pneumoniae is reported in various regions in the world, however, data of the clinical significance is rare. Increased ${\beta}$-lactamase production of Haemophilus influenzae urges us to use ${\beta}-lactam/{\beta}-lactamase$ or 3rd generation cephalosporin if Haemophilus is pathogen. Pneumococcal vaccine usage is an effective way to prevent invasive diseases by S. pneumoniae (including resistant pathogen). The rate of pneumococcal vaccination in Korea is very low (0.8% in adult). Strategies to control resistance that include effective antimicrobial treatment, vaccination, infection control, appropriate policies and regulations, 'antibiotic stewardship' and education of appropriate antibiotic use, are greatly in need.

Keywords

References

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