Editorial Response: A New Fluoroquinolone for Community-Acquired Pneumonia

Symptoms of respiratory infection are a major reason that The 1993 ATS guidelines recommended either a macrolide or a tetracycline for treatment of patients younger than 60 yearspatients visit their physicians, especially during the winter sea-of age with ‘‘no co-morbidities.’ ’ This seemed logical in view ofson. Perhaps the most common infectious disorder in children the 10%–20 % of patients with community-acquired pneumoniais otitis media, while sinusitis, bronchitis, and pharyngitis are who have respiratory infections caused by Legionella pneumoph-frequent complaints of adults seeking medical care. Of the condi-ila, Chlamydia pneumoniae, or Mycoplasma pneumoniae (antions that appear to be most serious, community-acquired pneu-aggregate percentage that has not been significantly differentmonia has attracted considerable recent attention. All physicians than that for Streptococcus pneumoniae) [3]. On the other hand,are aware of the potential fatal consequences of bacteremic pneu-it has been argued that pneumococcal disease is potentially moremococcal pneumonia and untreated legionnaires ’ disease. lethal than infections due to M. pneumoniae or C. pneumoniaeIn keeping with modern health care trends, the American and that the therapy should be targeted against the pathogensThoracic Society (ATS) published in 1993 guidelines for the that are most likely to cause high mortality [4].management of community-acquired pneumonia [1]. The pub-While the debate about the 1993 ATS guidelines continues,lication of these guidelines triggered considerable debate in revision of these guidelines as well as other recommendationsboth the academic and practice-oriented communities. Publica-from societies such as the Infectious Diseases Society oftion of such guidelines reflects the inexorable movement towar