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Letters |18 May 1999

Therapy for Legionnaires Disease

Paul H. Edelstein, MD

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  • University of Pennsylvania Medical Center; Philadelphia, PA 19101-4283 (Edelstein)
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Dr. Johnson raises the important issue of empirical therapy for community-acquired pneumonia. The decision of whether to include treatment of Legionnaires disease in such therapy must be based on the chances of the patient having the disease and on the potential for harm if the disease is untreated. He rightly points out that there is great potential for the emergence of fluoroquinolone antimicrobial resistance if every patient with pneumonia receives that therapy. Empirical administration of a narrow-spectrum β-lactam antimicrobial agent alone may not be adequate therapy for several community-acquired infectious agents, including Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, as well as Legionella species. Immunocompromised or previously hospitalized patients have the additional possibility of having infection caused by other, often multiresistant, pathogens.
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Edelstein PH. Therapy for Legionnaires Disease. Ann Intern Med. 1999;130:864. doi: 10.7326/0003-4819-130-10-199905180-00014

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Published: Ann Intern Med. 1999;130(10):864.

DOI: 10.7326/0003-4819-130-10-199905180-00014

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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