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The study by Malcom and Marrie¹ reveals the alarming prevalence of inappropriate fluoroquinolone use for community-acquired pneumonia (CAP) in a sample of emergency departments. Community-acquired pneumonia remains the most common infectious cause of death; thus, the widespread use of fluoroquinolones leading to emergence of resistant pneumococcus and gram-negative organisms seldom implicated in CAP is worrisome.² One of the obstacles in educating practitioners treating CAP to limit the use of fluoroquinolones to those deemed appropriate for such therapy¹ is the lack specific recommendations for the treatment of CAP by guidelines published by the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA). In outpatient CAP, the IDSA recommends doxycycline, a macrolide, or a fluoroquinolone in no specific order of preference.³ Although the latest ATS guidelines for outpatient treatment of CAP recommend reserving fluoroquinolones for patients with cardiopulmonary disease, the ATS makes no distinction in preference among a -lactam plus . . . [Full Text of this Article]

Join Y. Luh, MD; Bernard M. Karnath, MD
Galveston, Tex