1. Treatment strategies forLegionellainfection
- Author
-
M. Luisa Pedro-Botet and Victor L. Yu
- Subjects
medicine.medical_specialty ,Legionella ,Microbial Sensitivity Tests ,Hospital-acquired pneumonia ,Azithromycin ,Legionella pneumophila ,Community-acquired pneumonia ,Levofloxacin ,medicine ,Animals ,Humans ,Pharmacology (medical) ,Intensive care medicine ,Pharmacology ,Clinical Trials as Topic ,biology ,business.industry ,General Medicine ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,Anti-Bacterial Agents ,respiratory tract diseases ,Disease Models, Animal ,Pneumonia ,bacteria ,Drug Therapy, Combination ,Legionnaires' disease ,Legionnaires' Disease ,business ,medicine.drug - Abstract
Given the nonspecific clinical manifestations of Legionnaires' disease and the high mortality of untreated Legionnaires' disease, we recommend routine use of Legionella testing, especially the Legionella urinary antigen test, for all patients with community-acquired pneumonia. This includes patients with ambulatory pneumonia and hospitalized children. Legionella cultures should be more widely available, especially in hospitals where the drinking water is colonized with Legionella. Azithromycin or levofloxacin can be considered as first-line therapy. Other antibiotics including tetracyclines, tigecycline, other fluoroquinolones and other macrolides (especially clarithromycin) are also effective. The clinical response of quinolones may be somewhat more favorable compared to macrolides, but the outcome is similar. If the Legionnaires' disease is hospital-acquired, culturing of the hospital drinking water for Legionella is indicated.
- Published
- 2009