Community- Acquired Pneumonia

To the Editor: Wunderink and Waterer (Feb. 6 issue)(1) summarize antimicrobial agents, including fluoroquinolones, that are safe and effective for the treatment of community-acquired pneumonia. However, the appropriateness of antimicrobial therapy also depends on the spectrum of activity. In this context, the routine use of fluoroquinolones to treat community-acquired pneumonia is inappropriate. Fluoroquinolones are the only oral antibiotics with reliable activity against gram-negative bacilli, yet increasing resistance is rapidly eliminating them as the last oral treatment option for common community-associated infections (e.g., kidney, abdominal, and prostate infections) and health care-associated gram-negative infections (including pneumonia). The routine use of these active ...