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Decalogue for the selection of oral antibiotics for lower respiratory tract infections

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Canton, Rafael
  • Barberan, Jose
  • Linares, Manuel
  • Maria Molero, Jose
  • Miguel Rodriguez-Gonzalez-Moro, Jose
  • Gonzalez del Castillo, Juan

Grupos

Abstract

Lower respiratory tract infections, including chronic obstructive pulmonary disease exacerbations (COPD-E) and community acquired pneumonia (CAP), are one of the most frequent reasons for consultation in primary care and hospital emergency departments, and are the cause of a high prescription of antimicrobial agents. The selection of the most appropriate oral antibiotic treatment is based on different aspects and includes to first consider a bacterial aetiology and not a viral infection, to know the bacterial pathogen that most frequently cause these infections and the frequency of their local antimicrobial resistance. Treatment should also be prescribed quickly and antibiotics should be selected among those with a quicker mode of action, achieving the greatest effect in the shortest time and with the fewest adverse effects (toxicity, interactions, resistance and/or ecological impact). Whenever possible, antimicrobials should be rotated and diversified and switched to the oral route as soon as possible. With these premises, the oral treatment guidelines for mild or moderate COPD-E and CAP in Spain include as first options betalactam antibiotics (amoxicillin and amoxicillin-clavulanate and cefditoren), in certain situations associated with a macrolide, and relegating fluoroquinolones as an alternative, except in cases where the presence of Pseudomonas aeruginosa is suspected.

©The Author 2022. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).

Datos de la publicación

ISSN/ISSNe:
0214-3429, 1988-9518

REVISTA ESPANOLA DE QUIMIOTERAPIA  SOCIEDAD ESPANOLA QUIMIOTERAPIA

Tipo:
Article
Páginas:
16-29
PubMed:
35041328
Factor de Impacto:
0,440 SCImago ℠
Cuartil:
Q3 SCImago ℠

Citas Recibidas en Web of Science: 8

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Keywords

  • respiratory tract infections; bacterial infections; oral treatment; antibiotic use; antimicrobial resistance

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