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New Clues, but No Definitive Answers

Arch Intern Med. 1999;159:2511-2512.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

EMPIRIC SELECTION of antimicrobial agents to treat patients hospitalized with pneumonia should provide coverage for the most common treatable pathogens and also those most likely to cause severe disease, but no regimen covers all possible pathogens. With the accumulation of evidence that Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila cause a substantial proportion of pneumonia, and that L pneumophila is more likely to cause severe disease, it is reasonable to provide empiric coverage for these organisms. Two articles in this issue seem to lend strong support to this contention by providing evidence that adding a macrolide to empiric coverage decreases the length of hospitalization¹ or reduces mortality,² but because neither study randomized patients, these conclusions should be interpreted with caution.

The excellent study by Gleason and colleagues² compared the 30-day mortality for patients treated with a nonpseudomonal, third-generation cephalosporin alone with patients treated with several other initial antibiotic . . . [Full Text of this Article]

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