Epidemiologie, Diagnostik, antimikrobielle Therapie und Management von erwachsenen Patienten mit ambulant erworbenen unteren Atemwegsinfektionen sowie ambulant erworbener Pneumonie – Update 2009

 

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Inhalt 1. Struktur der Leitlinie e6 1.1.Vorwort e61.2. Ziele der Leitliniee6 1.3. Erstellung der Leitliniee71.3.1. Literaturrecherchee71.3.2. Formulierung der Empfehlungene71.4. Finanzierunge81.5. Implementierung/Publikatione81.6. Planmäßige Überarbeitunge81.7. Prozessqualität e8 2. Definitionen e8 3. Epidemiologie und sozialmedizinische Bedeutung e9 4. Erregerspektrum e9 5. Resistenzsituation e10 5.1. Resistenzsituation bei Streptococcus pneumoniae e105.1.1. Resistenz gegenüber Penicillin G e105.1.2. Resistenz gegenüber Makroliden e105.1.3. Resistenz gegenüber Fluorchinolonen e115.1.4. Resistenz gegenüber Tetracyclinen e115.2. Resistenzsituation bei Haemophilus influenzae e115.3. Resistenzsituation bei Moraxella catarrhalis e115.4. Resistenzsituation bei Enterobacteriaceae und Pseudomonas aeruginosa e115.5. Resistenzsituation bei Influenza-Viren und nicht primär respiratorischen Viren e12 6. Mikrobiologische Diagnostik e12 6.1. Diagnostik schnell wachsender Bakterien e126.2. Diagnostik spezieller Erreger e136.2.1. Diagnostik von Legionella pneumophila e136.2.2. Diagnostik von Mycoplasma pneumoniae e146.2.3. Diagnostik von Chlamydophila pneumoniae e156.2.4. Diagnostik respiratorischer Viren e15 7. Antiinfektiva zur Behandlung tiefer Atemwegsinfektionen e16 7.1. Betalaktamantibiotika e167.1.1. Orale Basispenicilline: Penicillin V und Amoxicillin e167.1.2. Parenterale Basispenicilline: Penicillin G und Ampicillin e167.1.3. Aminopenicillin-Betalaktamaseinhibitor-Kombinationen e167.1.4. Oralcephalosporine e167.1.5. Parenterale Cephalosporine e177.1.6. Ertapenem e177.1.7. Pseudomonaswirksame Betalaktame e187.2. Tetracycline: Doxycyclin e187.3. Makrolide und Azalide e187.4. Lincosamide: Clindamycin e197.5. Fluorchinolone e197.5.1. Levofloxacin und Moxifloxacin e197.5.2. Ciprofloxacin e207.6. Oxazolidinone: Linezolid e207.7. Influenzaviruswirksame Virustatika e207.8. Aciclovir e21 8. Symptomatik und Befunde bei unteren Atemwegsinfektionen e21 8.1. Symptomatik e218.2. Untersuchung e22 9. Behandlung Non-CAP: akute Bronchitis, Influenzainfektion, andere respiratorische Virusinfektionen e22 9.1. Akute Bronchitis e229.2. Influenzainfektion e239.3. Andere respiratorische Virusinfektionen e24 10. Akute Exazerbation der COPD (AECOPD) e24 10.1. Definition der AECOPD e2410.2. Ätiologie der AECOPD e2410.3. Klinische Symptomatik der AECOPD e2510.4. Mikrobiologische Diagnostik der AECOPD e2610.5. Indikation zur antimikrobiellen Therapie bei AECOPD e2610.5.1. Pathogenetische Überlegungen zur Therapieindikation bei AECOPD e2610.5.2. Begründung der Therapieempfehlung e2710.6. Auswahl der antimikrobiellen Therapie bei AECOPD e2810.7. Verlauf der antimikrobiellen Therapie bei AECOPD e29 11. Risikostratifizierung der CAP e30 11.1. Entscheidung zur stationären Einweisung e3011.2. Entscheidung zur Aufnahme auf eine Intensivstation (ITS), Intermediärstation bzw. Station mit intensivierter Überwachung e3011.3 Einteilung der CAP e32 12. Ambulantes Management der CAP e32 12.1. CAP bei ambulanten Patienten ohne Risikofaktoren e3212.1.1. Erregerspektrum bei ambulanten CAP-Patienten ohne Risikofaktoren e3212.1.2. Diagnostik bei ambulanten Patienten ohne Risikofaktoren e3312.1.3. Therapie bei ambulanten CAP-Patienten ohne Risikofaktoren e3312.1.4. Verlauf bei ambulanten CAP-Patienten ohne Risikofaktoren e3312.2. CAP bei ambulanten Patienten mit Risikofaktoren e3412.2.1. Erregerspektrum bei ambulanten CAP-Patienten mit Risikofaktoren e3412.2.2. Diagnostik bei ambulanten CAP-Patienten mit Risikofaktoren e3412.2.3. Therapie bei ambulanten CAP-Patienten mit Risikofaktoren e3412.2.4. Verlauf bei ambulanten CAP-Patienten mit Risikofaktoren e35 13. Management bei hospitalisierten CAP-Patienten e35 13.1. Erregerspektrum bei hospitalisierten CAP-Patienten e3513.2. Diagnostik bei hospitalisierten CAP-Patienten e3613.3. Therapie bei hospitalisierten CAP-Patienten e3613.4. Verlauf bei hospitalisierten CAP-Patienten e39 14. Management der schweren ambulant erworbenen Pneumonie (schwere CAP) e40 14.1. Erregerspektrum der schweren ambulant erworbenen Pneumonie (sCAP) e4014.2. Diagnostik bei schwerer ambulant erworbener Pneumonie (sCAP) e4114.3. Therapie der schweren ambulant erworbenen Pneumonie (sCAP) e42 15.Therapieversagen bei CAP e45 15.1. Häufigkeit und Ursachen des Therapieversagens e4515.2. Diagnostisches Vorgehen e4515.3. Antibiotikatherapie bei Therapieversagen e46 16. Besondere Verlaufsformen der CAP e46 16.1. Pleuraerguss e4616.2. Aspirationspneumonie e4716.3. Retentionspneumonie e4716.4. Lungenabszess e4716.5. Pseudo-Therapieversager durch nichtinfektiöse Lungenerkrankungen, die initial wie eine Pneumonie imponieren e48 17. Besonderheiten der Therapie der CAP bei bekanntem Erreger e48 17.1. Legionellen e4817.2. Chlamydien und Mykoplasmen e4917.3. Ambulant erworbener methicillin-resistenter Staphylococcus aureus e4917.4. Pseudomonas aeruginosa e4917.5. Coxiella burnetii e50 18. Prävention der CAP e50 18.1. Influenzavirus-Impfung e5018.2. Pneumokokken-Impfung e5018.3. Sonstige präventive Maßnahmen e51 19. Pharmakoökonomische Bewertung der Evidenzlage zur CAP e51 20. CAP als terminales Ereignis bei hohem Lebensalter und/oder schwerer fortgeschrittener Komorbidität e52 21. Anhang e55 21.1. Autoren der Leitlinie e5521.2. Zur Konsensuskonferenz am 9. 12. 2008 eingeladene und vertretene Fachgesellschaften und Einrichtungen e5521.3. Teilnehmer der Konsensuskonferenz e5521.4. Erklärung über mögliche Interessenkonflikte e5621.5. Abkürzungsverzeichnis e56 22. Literaturverzeichnise57 Die nach der Literaturstelle in Klammern gesetzte Ziffer mit Buchstaben bezieht sich auf die Evidenzbewertung nach Oxford Centre of Evidence Based Medicine (1999).

22. Literaturverzeichnis

• 1 Capelastegui A, Espana P P, Quintana J M. et al . Improvement of process-of-care and outcomes after implementing a guideline for the management of community-acquired pneumonia: a controlled before-and-after design study.  Clin Infect Dis. 2004;  39 955-963 (2b)
  CrossrefPubMedGoogle Scholar
• 2 Dean N C, Silver M P, Bateman K A. et al . Decreased mortality after implementation of a treatment guideline for community-acquired pneumonia.  Am J Med. 2001;  110 451-457 (2b)
  CrossrefPubMedGoogle Scholar
• 3 Gleason P P, Kapoor W N, Stone R A. et al . Medical outcomes and antimicrobial costs with the use of the American Thoracic Society guidelines for outpatients with community-acquired pneumonia.  JAMA. 1997;  278 32-39 (2c)
  CrossrefPubMedGoogle Scholar
• 4 Al Eidan F A, McElnay J C, Scott M G. et al . Use of a treatment protocol in the management of community-acquired lower respiratory tract infection.  J Antimicrob Chemother. 2000;  45 387-394 (2b)
  CrossrefPubMedGoogle Scholar
• 5 Brown R B, Iannini P, Gross P, Kunkel M. Impact of initial antibiotic choice on clinical outcomes in community-acquired pneumonia: analysis of a hospital claims-made database.  Chest. 2003;  123 1503-1511 (2b)
  CrossrefPubMedGoogle Scholar
• 6 Lorenz W, Ollenschläger G. Das Leitlinien-Manual.  Z Arztl Fortbild Qualitatssich. 2001;  95 1-84 (5)
  PubMedGoogle Scholar
• 7 American Thoracic Society . Hospital-acquired pneumonia in adults: Diagnosis, assessment, initial therapy, and prevention: A consensus statement.  Am J Respir Crit Care Med. 1996;  153 1711-1725 (5)
  PubMedGoogle Scholar
• 8 American Thoracic Society . Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia.  Am J Respir Crit Care Med. 2005;  171 388-416 (5)
  CrossrefPubMedGoogle Scholar
• 9 Tablan O C, Anderson L J, Besser R. et al . Guidelines for preventing health-care-associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee.  MMWR Recomm Rep. 2004;  53 1-36 (5)
  PubMedGoogle Scholar
• 10 Toubes E, Singh K, Yin D. et al . Risk factors for antibiotic-resistant infection and treatment outcomes among hospitalized patients transferred from long-term care facilities: does antimicrobial choice make a difference?.  Clin Infect Dis. 2003;  36 724-730 (2c)
  CrossrefPubMedGoogle Scholar
• 11 Kollef M H, Shorr A, Tabak Y P. et al . Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia.  Chest. 2005;  128 3854-3862 (2c)
  CrossrefPubMedGoogle Scholar
• 12 Carratala J, Mykietiuk A, Fernandez-Sabe N. et al . Health care-associated pneumonia requiring hospital admission: epidemiology, antibiotic therapy, and clinical outcomes.  Arch Intern Med. 2007;  167 1393-1399 (2b)
  CrossrefPubMedGoogle Scholar
• 13 El Solh A A, Pietrantoni C, Bhat A. et al . Indicators of potentially drug-resistant bacteria in severe nursing home-acquired pneumonia.  Clin Infect Dis. 2004;  39 474-480 (2b)
  CrossrefPubMedGoogle Scholar
• 14 Loeb M, Carusone S C, Goeree R. et al . Effect of a Clinical Pathway to Reduce Hospitalizations in Nursing Home Residents With Pneumonia: A Randomized Controlled Trial.  JAMA: The Journal of the American Medical Association. 2006;  295 2503-2510 (1b)
  CrossrefPubMedGoogle Scholar
• 15 Worth G, Buhl R, Cegla U. et al . Leitlinie der Deutschen Atemwegsliga und der Deutschen Gesellschaft für Pneumologie zur Diagnostik und Therapie von Patienten mit chronisch obstruktiver Bronchitis und Lungenemphysem (COPD).  Pneumologie. 2002;  56 704-738 (4)
  Article in Thieme ConnectPubMedGoogle Scholar
• 16 Vogelmeier C, Buhl R, Criee C P. et al . Leitlinie der Deutschen Atemwegsliga und der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin zur Diagnostik und Therapie von Patienten mit chronisch obstruktiver Bronchitis und Lungenemphysem (COPD).  Pneumologie. 2007;  61 e1-e40 (5)
  Article in Thieme ConnectPubMedGoogle Scholar
• 17 Dalhoff K, Ewig S, Höffken G. et al . Empfehlungen zur Diagnostik, Therapie und Prävention von Pneumonien bei erworbenem Immundefizit.  Pneumologie. 2003;  56 807-831 (5)
  Article in Thieme ConnectPubMedGoogle Scholar
• 18 Lopez A D, Murray C C. The global burden of disease, 1990 – 2020.  Nat Med. 1998;  4 1241-1243 (5)
  CrossrefPubMedGoogle Scholar
• 19 Marrie T J, Lau C Y, Wheeler S L. et al . A controlled trial of a critical pathway for treatment of community-acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin.  JAMA. 2000;  283 749-755 (1b)
  CrossrefPubMedGoogle Scholar
• 20 Bauer T T, Ewig S, Marre R. et al . CRB-65 predicts death from community-acquired pneumonia.  J Intern Med. 2006;  260 93-101 (2c)
  CrossrefPubMedGoogle Scholar
• 21 Buist A S, McBurnie M A, Vollmer W M. et al . International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study.  Lancet. 2007;  370 741-750 (2c)
  CrossrefPubMedGoogle Scholar
• 22 Nowak D, Dietrich E S, Oberender P. et al . Krankheitskosten von COPD in Deutschland.  Pneumologie. 2004;  58 837-844 (4)
  Article in Thieme ConnectPubMedGoogle Scholar
• 23 Fang G D, Fine M, Orloff J. et al . New and emerging etiologies for community-acquired pneumonia with implications for therapy. A prospective multicenter study of 359 cases.  Medicine. 1990;  69 307-316 (4)
  PubMedGoogle Scholar
• 24 Lim W S, Macfarlane J T, Boswell T C. et al . Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines.  Thorax. 2001;  56 296-301 (4)
  CrossrefPubMedGoogle Scholar
• 25 Ruiz M, Ewig S, Marcos M A. et al . Etiology of community-acquired pneumonia in hospitalized patients: Impact of age, comorbidity and severity.  Am J Respir Crit Care Med. 1999;  160 397-405 (2c)
  PubMedGoogle Scholar
• 26 Welte T, Marre R, Suttorp N. What is new in the treatment of community-acquired pneumonia?.  Med Klin (Munich). 2006;  101 313-320 (4)
  CrossrefPubMedGoogle Scholar
• 27 Baum H von, Ewig S, Marre R. et al . Community-acquired Legionella pneumonia: new insights from the German competence network for community acquired pneumonia.  Clin Infect Dis. 2008;  46 1356-1364 (4)
  CrossrefPubMedGoogle Scholar
• 28 Wellinghausen N, Straube E, Freidank H. et al . Low prevalence of Chlamydia pneumoniae in adults with community-acquired pneumonia.  Int J Med Microbiol. 2006;  296 485-491 (4)
  CrossrefPubMedGoogle Scholar
• 29 Arancibia F, Bauer T T, Ewig S. et al . Community-acquired Pneumonia caused by Gram-negative bacteria: Incidence and risk and prognosis.  Arch Intern Med. 2002;  162 1849-1858 (2c)
  CrossrefPubMedGoogle Scholar
• 30 Bodi M, Rodriguez A, Sole-Violan J. et al . Antibiotic Prescription for Community-Acquired Pneumonia in the Intensive Care Unit: Impact of Adherence to Infectious Diseases Society of America Guidelines on Survival.  Clinical Infectious Diseases. 2005;  41 1709-1716 (2c)
  CrossrefPubMedGoogle Scholar
• 31 Bartlett J G, Mundy L M. Community-Acquired Pneumonia.  The New England Journal of Medicine. 1995;  333 1618-1624 (5)
  CrossrefPubMedGoogle Scholar
• 32 Clavo-Sanchez A J, Giron-Gonzalez J A, Lopez-Prieto D. et al . Multivariate analysis of risk factors for infection due to penicillin-resistant and multidrug-resistant Streptococcus pneumoniae: A multicenter study.  Clin Infect Dis. 1997;  24 1052-1059 (2c)
  CrossrefPubMedGoogle Scholar
• 33 Vanderkooi O G, Low D E, Green K. et al . Predicting antimicrobial resistance in invasive pneumococcal infections.  Clin Infect Dis. 2005;  40 1288-1297 (2c)
  CrossrefPubMedGoogle Scholar
• 34 Ray G T, Baxter R, DeLorenze G N. Hospital-level rates of fluoroquinolone use and the risk of hospital-acquired infection with ciprofloxacin-nonsusceptible Pseudomonas aeruginosa.  Clin Infect Dis. 2005;  41 441-449 (2c)
  CrossrefPubMedGoogle Scholar
• 35 Nseir S, Di P C, Soubrier S. et al . First-generation fluoroquinolone use and subsequent emergence of multiple drug-resistant bacteria in the intensive care unit.  Crit Care Med. 2005;  33 283-289 (2c)
  CrossrefPubMedGoogle Scholar
• 36 LeBlanc L, Pepin J, Toulouse K. et al . Fluoroquinolones and risk for methicillin-resistant Staphylococcus aureus, Canada.  Emerg Infect Dis. 2006;  12 1398-1405 (2c)
  CrossrefPubMedGoogle Scholar
• 37 Charbonneau P, Parienti J J, Thibon P. et al . Fluoroquinolone use and methicillin-resistant Staphylococcus aureus isolation rates in hospitalized patients: a quasi experimental study.  Clin Infect Dis. 2006;  42 778-784 (2b)
  CrossrefPubMedGoogle Scholar
• 38 Paterson D L, Ko W C, Von G A. et al . International prospective study of Klebsiella pneumoniae bacteremia: implications of extended-spectrum beta-lactamase production in nosocomial Infections.  Ann Intern Med. 2004;  140 26-32 (2c)
  PubMedGoogle Scholar
• 39 Lück P C, Lobeck G, Stenzel G. et al . Legionella pneumonia after travel to Mediterranean countries.  Z Ärztl Fortbild (Jena). 1994;  88 433-436 (4)
  PubMedGoogle Scholar
• 40 Höffken G, Steinhoff D, Lode H. et al . Ätiologie von ambulant erworbenen Pneumonien bei älteren Menschen.  Chemotherapie J. 1995;  4 13-19 (4)
  PubMedGoogle Scholar
• 41 Garcia-Ordonez M A, Garcia-Jimenez J M, Paez F. et al . Clinical aspects and prognostic factors in elderly patients hospitalised for community-acquired pneumonia.  Eur J Clin Microbiol Infect Dis. 2001;  20 14-19 (2c)
  PubMedGoogle Scholar
• 42 Woodhead M. Pneumonia in the elderly.  J Antimicrob Chemother. 1994;  34 Suppl A 85-92 (5)
  PubMedGoogle Scholar
• 43 Riquelme R, Torres A, El-Ebiary M. et al . Community-acquired pneumonia in the elderly: a multivariate analysis of risk and prognostic factors.  Am J Respir Crit Care Med. 1996;  154 1450-1455 (2c)
  PubMedGoogle Scholar
• 44 Paganin F, Lilienthal F, Bourdin A. et al . Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor.  European Respiratory Journal. 2004;  24 779-785 (2c)
  CrossrefPubMedGoogle Scholar
• 45 El Solh A A, Sikka P, Ramadan F, Davies J. Etiology of severe pneumonia in the very elderly.  Am J Respir Crit Care Med. 2001;  163 645-651 (2c)
  PubMedGoogle Scholar
• 46 Quagliarello V, Ginter S, Han L. et al . Modifiable risk factors for nursing home-acquired pneumonia.  Clin Infect Dis. 2005;  40 1-6 (2c)
  CrossrefPubMedGoogle Scholar
• 47 Sopena N, Sabria M, Pedro-Botet M L. et al . Prospective study of community-acquired pneumonia of bacterial etiology in adults.  Eur J Clin Microbiol Infect Dis. 1999;  18 852-858 (4)
  CrossrefPubMedGoogle Scholar
• 48 Arancibia F, Ewig S, Martinez J A. et al . Antimicrobial treatment failures in patients with community-acquired pneumonia: Causes and prognostic implications.  Am J Respir Crit Care Med. 2000;  162 154-160 (2c)
  CrossrefPubMedGoogle Scholar
• 49 Bartlett J G, Dowell S F, Mandell L A. et al . Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America.  Clin Infect Dis. 2000;  31 422-425 (5)
  CrossrefPubMedGoogle Scholar
• 50 Leroy O, Santre C, Beuscart C. et al . A five-year study of severe community-acquired pneumonia with emphasis on prognosis in patients admitted to an intensive care unit.  Intensive Care Med. 1995;  21 24-31 (2c)
  CrossrefPubMedGoogle Scholar
• 51 Niederman M S, Mandell L A, Anzueto A. et al . Guidelines for the Management of Adults with Community-acquired Pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention.  Am J Respir Crit Care Med. 2001;  163 1730-1754 (5)
  CrossrefPubMedGoogle Scholar
• 52 Nseir S, Di P C, Cavestri B. et al . Multiple-drug-resistant bacteria in patients with severe acute exacerbation of chronic obstructive pulmonary disease: Prevalence, risk factors, and outcome.  Crit Care Med. 2006;  34 2959-2966 (2c)
  PubMedGoogle Scholar
• 53 Rello J, Rodriguez A, Torres A. Implications of COPD in patients admitted to the intensive care unit by community-acquired pneumonia.  Eur Respir J. 2006;  27 1210-1216 (3b)
  CrossrefPubMedGoogle Scholar
• 54 Kobashi Y, Okimoto N, Matsushima T, Soejima R. Clinical analysis of community-acquired pneumonia in the elderly.  Intern Med. 2001;  40 703-707 (4)
  CrossrefPubMedGoogle Scholar
• 55 Falsey A R, Walsh E E. Viral pneumonia in older adults.  Clin Infect Dis. 2006;  42 518-524 (5)
  CrossrefPubMedGoogle Scholar
• 56 de Roux A, Marcos M A, Garcia E. et al . Viral Community-Acquired Pneumonia in Nonimmunocompromised Adults.  Chest. 2004;  125 1343-1351 (2c)
  CrossrefPubMedGoogle Scholar
• 57 Angeles M M, Camps M, Pumarola T. et al . The role of viruses in the aetiology of community-acquired pneumonia in adults.  Antivir Ther. 2006;  11 351-359 (2b)
  PubMedGoogle Scholar
• 58 Robertson L, Caley J P, Moore J. Importance of Staphylococcus aureus in pneumonia in the 1957 epidemic of influenza A.  Lancet. 1958;  2 233-236 (4)
  PubMedGoogle Scholar
• 59 Ruiz M, Ewig S, Torres A. et al . Severe community-acquired pneumonia. Risk factors and follow-up epidemiology.  Am J Respir Crit Care Med. 1999;  160 923-929 (2c)
  PubMedGoogle Scholar
• 60 Deeks S L, Palacio R, Ruvinsky R. et al . Risk factors and course of illness among children with invasive penicillin-resistant Streptococcus pneumoniae.The Streptococcus pneumoniae Working Group.  Pediatrics. 1999;  103 409-413 (2c)
  CrossrefPubMedGoogle Scholar
• 61 Henriques B, Kalin M, Ortqvist A. et al . Molecular epidemiology of Streptococcus pneumoniae causing invasive disease in 5 countries.  J Infect Dis. 2000;  182 833-839 (4)
  CrossrefPubMedGoogle Scholar
• 62 Moroney J F, Fiore A E, Harrison L H. et al . Clinical outcomes of bacteremic pneumococcal pneumonia in the era of antibiotic resistance.  Clin Infect Dis. 2001;  33 797-805 (2c)
  CrossrefPubMedGoogle Scholar
• 63 Pallares R, Linares J, Vadillo M. et al . Resistance to penicillin and cephalosporin and mortality from severe pneumococcal pneumonia in Barcelona, Spain.  N Engl J Med. 1995;  333 474-480 (4)
  CrossrefPubMedGoogle Scholar
• 64 Yu V L, Chiou C C, Feldman C. et al . An international prospective study of pneumococcal bacteremia: correlation with in vitro resistance, antibiotics administered, and clinical outcome.  Clin Infect Dis. 2003;  37 230-237 (2c)
  CrossrefPubMedGoogle Scholar
• 65 Feikin D RJ, Schuchat A, Kolczak M. et al . Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995 – 1997.  Am J Public Health. 2000;  90 223-229 (2b)
  CrossrefPubMedGoogle Scholar
• 66 Reinert R R, Al-Lahham A, Lemperle M. et al . Emergence of macrolide and penicillin resistance among invasive pneumococcal isolates in Germany.  J Antimicrob Chemother. 2002;  49 61-68 (4)
  CrossrefPubMedGoogle Scholar
• 67 Reinert R R, Al-Lahham A, Lutticken R. et al . Characterization of clinical Streptococcus pneumoniae strains from Germany with decreased susceptibility to fluoroquinolones.  J Antimicrob Chemother. 2002;  49 1015-1018 (4)
  CrossrefPubMedGoogle Scholar
• 68 Reinert R R, Reinert S, van der Linden M. et al . Antimicrobial susceptibility of Streptococcus pneumoniae in eight European countries from 2001 to 2003.  Antimicrob Agents Chemother. 2005;  49 2903-2913 (4)
  CrossrefPubMedGoogle Scholar
• 69 van der Linden M, Al-Lahham A, Haupts S, Reinert R R. Clonal spread of mef-positive macrolide-resistant Streptococcus pneumoniae isolates causing invasive disease in adults in Germany.  Antimicrob Agents Chemother. 2007;  51 1830-1834 (4)
  CrossrefPubMedGoogle Scholar
• 70 van der Linden M, Heeg C, Imöhl M, Reinert R R. Annual report of the National Reference Centre for Streptococci, 2007.  International Journal of Medical Microbiology. 2008;  298S2 RKP04 (4)
  PubMedGoogle Scholar
• 71 Fogarty C, Goldschmidt R, Bush K. Bacteremic pneumonia due to multidrug-resistant pneumococci in 3 patients treated unsuccessfully with azithromycin and successfully with levofloxacin.  Clin Infect Dis. 2000;  31 613-615 (4)
  CrossrefPubMedGoogle Scholar
• 72 Kelley M A, Weber D J, Gilligan P, Cohen M S. Breakthrough pneumococcal bacteremia in patients being treated with azithromycin and clarithromycin.  Clin Infect Dis. 2000;  31 1008-1011 (4)
  CrossrefPubMedGoogle Scholar
• 73 Waterer G W, Wunderink R G, Jones C B. Fatal pneumococcal pneumonia attributed to macrolide resistance and azithromycin monotherapy.  Chest. 2000;  118 1839-1840 (4)
  CrossrefPubMedGoogle Scholar
• 74 Kays M B, Wack M F, Smith D W, Denys G A. Azithromycin treatment failure in community-acquired pneumonia caused by Streptococcus pneumoniae resistant to macrolides by a 23S rRNA mutation.  Diagn Microbiol Infect Dis. 2002;  43 163-165 (4)
  CrossrefPubMedGoogle Scholar
• 75 Musher D M, Dowell M E, Shortridge V D. et al . Emergence of macrolide resistance during treatment of pneumococcal pneumonia.  N Engl J Med. 2002;  346 630-631 (4)
  CrossrefPubMedGoogle Scholar
• 76 Lonks J R, Garau J, Gomez L. et al . Failure of macrolide antibiotic treatment in patients with bacteremia due to erythromycin-resistant Streptococcus pneumoniae.  Clin Infect Dis. 2002;  35 556-564 (3b)
  CrossrefPubMedGoogle Scholar
• 77 Van Kerkhoven D, Peetermans W E, Verbist L, Verhaegen J. Breakthrough pneumococcal bacteraemia in patients treated with clarithromycin or oral beta-lactams.  J Antimicrob Chemother. 2003;  51 691-696 (4)
  CrossrefPubMedGoogle Scholar
• 78 Daneman N, McGeer A, Green K, Low D E. Macrolide resistance in bacteremic pneumococcal disease: implications for patient management.  Clin Infect Dis. 2006;  43 432-438 (2c)
  CrossrefPubMedGoogle Scholar
• 79 Malhotra-Kumar S, Lammens C, Coenen S. et al . Effect of azithromycin and clarithromycin therapy on pharyngeal carriage of macrolide-resistant streptococci in healthy volunteers: a randomised, double-blind, placebo-controlled study.  Lancet. 2007;  369 482-490 (1b)
  CrossrefPubMedGoogle Scholar
• 80 Descheemaeker P, Chapelle S, Lammens C. et al . Macrolide resistance and erythromycin resistance determinants among Belgian Streptococcus pyogenes and Streptococcus pneumoniae isolates.  J Antimicrob Chemother. 2000;  45 167-173 (4)
  CrossrefPubMedGoogle Scholar
• 81 Johnson D M, Sader H S, Fritsche T R. et al . Susceptibility trends of haemophilus influenzae and Moraxella catarrhalis against orally administered antimicrobial agents: five-year report from the SENTRY Antimicrobial Surveillance Program.  Diagn Microbiol Infect Dis. 2003;  47 373-376 (4)
  CrossrefPubMedGoogle Scholar
• 82 Davidson R, Cavalcanti R, Brunton J L. et al . Resistance to levofloxacin and failure of treatment of pneumococcal pneumonia.  N Engl J Med. 2002;  346 747-750 (4)
  CrossrefPubMedGoogle Scholar
• 83 Ross J J, Worthington M G, Gorbach S L. Resistance to levofloxacin and failure of treatment of pneumococcal pneumonia.  N Engl J Med. 2002;  347 65-67 (4)
  CrossrefPubMedGoogle Scholar
• 84 Anderson K B, Tan J S, File Jr. T M. et al . Emergence of levofloxacin-resistant pneumococci in immunocompromised adults after therapy for community-acquired pneumonia.  Clin Infect Dis. 2003;  37 376-381 (4)
  CrossrefPubMedGoogle Scholar
• 85 Felmingham D, Reinert R R, Hirakata Y, Rodloff A. Increasing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveillance study, and compatative in vitro activity of the ketolide, telithromycin.  J Antimicrob Chemother. 2002;  50 Suppl S1 25-37 (4)
  CrossrefPubMedGoogle Scholar
• 86 Canton R, Morosini M, Enright M C, Morrissey I. Worldwide incidence, molecular epidemiology and mutations implicated in fluoroquinolone-resistant Streptococcus pneumoniae: data from the global PROTEKT surveillance programme.  J Antimicrob Chemother. 2003;  52 944-952 (4)
  CrossrefPubMedGoogle Scholar
• 87 Reinert R R, Rodloff A C, Halle E. et al . Antibacterial resistance of community-acquired respiratory tract pathogens recovered from patients in Germany and activity of the Ketolide Telithromycin: results from the PROTEKT surveillance study (1999 – 2000).  Chemotherapy. 2004;  50 143-151 (4)
  CrossrefPubMedGoogle Scholar
• 88 Jacobs M R, Felmingham D, Appelbaum P C, Gruneberg R N. The Alexander Project 1998 – 2000: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents.  J Antimicrob Chemother. 2003;  52 229-246 (4)
  CrossrefPubMedGoogle Scholar
• 89 Johnson A P, Sheppard C L, Harnett S J. et al . Emergence of a fluoroquinolone-resistant strain of Streptococcus pneumoniae in England.  J Antimicrob Chemother. 2003;  52 953-960 (4)
  CrossrefPubMedGoogle Scholar
• 90 Blosser-Middleton R, Sahm D F, Thornsberry C. et al . Antimicrobial susceptibility of 840 clinical isolates of Haemophilus influenzae collected in four European countries in 2000 – 2001.  Clin Microbiol Infect. 2003;  9 431-436 (4)
  CrossrefPubMedGoogle Scholar
• 91 Kresken M, Hafner D, Schmitz F J, Wichelhaus T A. für die Studiengruppe .Resistenzsituation bei klinisch wichtigen Infektionserregern gegenüber Antibiotika in Deutschland und im mitteleuropäischen Raum. Bericht über die Ergebnisse einer multizentrischen Studie der Arbeitsgemeinschaft Empfindlichkeitsprüfungen & Resistenz der Paul-Ehrlich-Gesellschaft für Chemotherapie e. V. aus dem Jahr 2004. ISBN 3-00-018413-9. 2006
  PubMedGoogle Scholar
• 92 Mertens T, Haller O, Klenk H D. Diagnostik und Therapie von Viruskrankheiten: Leitlinien der Gesellschaft für Virologie. 2. Auflage. 2004 (5)
  PubMedGoogle Scholar
• 93 Mauch H, Wagner J, Marklein G. et al .MIQ 7 Qualitätsstandards in der mikrobiologisch-infektiologischen Diagnostik – Infektionen der unteren Atemwege. Teil 1. München; Urban & Fischer 1999: 30-50 (5)
  PubMedGoogle Scholar
• 94 Murray P R, Washington J A. Microscopic and bacteriologic analysis of expectorated sputum.  Mayo Clin Proc. 1975;  50 339-344 (4)
  PubMedGoogle Scholar
• 95 Geckler R W, Gremillion D H, McAllister C K, Ellenbogen C. Microscopic and bacteriological comparison of paired sputa and transtracheal aspirates.  J Clin Microbiol. 1977;  6 396-399 (4)
  PubMedGoogle Scholar
• 96 Roson B, Carratala J, Verdaguer R. et al . Prospective study of the usefulness of sputum Gram stain in the initial approach to community-acquired pneumonia requiring hospitalization.  Clin Infect Dis. 2000;  31 869-874 (2b)
  CrossrefPubMedGoogle Scholar
• 97 Mandell L A, Marrie T J, Grossman R F. et al . Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society. The Canadian Community-Acquired Pneumonia Working Group.  Clin Infect Dis. 2000;  31 385-421 (5)
  PubMedGoogle Scholar
• 98 Theerthakarai R, El Halees W, Ismail M. et al . Nonvalue of the Initial Microbiological Studies in the Management of Nonsevere Community-Acquired Pneumonia.  Chest. 2001;  119 181-184 (4)
  CrossrefPubMedGoogle Scholar
• 99 Chalasani N P, Valdecanas M A, Gopal A K. et al . Clinical utility of blood cultures in adult patients with community-acquired pneumonia without defined underlying risks.  Chest. 1995;  108 932-936 (4)
  CrossrefPubMedGoogle Scholar
• 100 Waterer G W, Wunderink R G. The influence of the severity of community-acquired pneumonia on the usefulness of blood cultures.  Respir Med. 2001;  95 78-82 (4)
  CrossrefPubMedGoogle Scholar
• 101 Lentino J R, Lucks D A. Nonvalue of sputum culture in the management of lower respiratory tract infections.  J Clin Microbiol. 1987;  25 758-762 (2b)
  PubMedGoogle Scholar
• 102 Dominguez J A, Matas L, Manterola J M. et al . Comparison of radioimmunoassay and enzyme immunoassay kits for detection of Legionella pneumophila serogroup 1 antigen in both concentrated and nonconcentrated urine samples.  J Clin Microbiol. 1997;  35 1627-1629 (2b)
  PubMedGoogle Scholar
• 103 Gutierrez F, Masia M, Rodriguez J C. et al . Evaluation of the Immunochromatographic Binax NOW Assay for Detection of Streptococcus pneumoniae Urinary Antigen in a Prospective Study of Community-Acquired Pneumonia in Spain.  Clin Infect Dis. 2003;  36 286-292 (4)
  CrossrefPubMedGoogle Scholar
• 104 Dominguez J, Gali N, Blanco S. et al . Detection of Streptococcus pneumoniae Antigen by a Rapid Immunochromatographic Assay in Urine Samples.  Chest. 2001;  119 243-249 (2b)
  CrossrefPubMedGoogle Scholar
• 105 Smith M D, Derrington P, Evans R. et al . Rapid diagnosis of bacteremic pneumococcal infections in adults by using the Binax NOW Streptococcus pneumoniae urinary antigen test: a prospective, controlled clinical evaluation.  J Clin Microbiol. 2003;  41 2810-2813 (2b)
  CrossrefPubMedGoogle Scholar
• 106 Marcos M A, Jimenez de Anta M T, de la Bellacasa J P. et al . Rapid urinary antigen test for diagnosis of pneumococcal community-acquired pneumonia in adults.  Eur Respir J. 2003;  21 209-214 (2b)
  CrossrefPubMedGoogle Scholar
• 107 Ishida T, Hashimoto T, Arita M. et al . A 3-Year prospective study of a urinary antigen-detection for Streptoccus pneumoniae in community acquired pneumonia: utility and clinical impact on the reported etiology.  J Infect Chemother. 2004;  10 359-363 (1b)
  CrossrefPubMedGoogle Scholar
• 108 Murdoch D R, Laing R T, Mills G D. et al . Evaluation of a rapid immunochromatographic test for detection of Streptococcus pneumoniae antigen in urine samples from adults with community-acquired pneumonia.  J Clin Microbiol. 2001;  39 3495-3498 (2b)
  CrossrefPubMedGoogle Scholar
• 109 Murdoch D R, Laing R T, Cook J M. The NOW S. pneumoniae urinary antigen test positivity rate 6 weeks after pneumonia onset and among patients with COPD.  Clin Infect Dis. 2003;  37 153-154 (4)
  CrossrefPubMedGoogle Scholar
• 110 Edelstein P H, Meyer R D, Finegold S M. Laboratory diagnosis of Legionnaires’ disease.  Am Rev Respir Dis. 1980;  121 317-327 (2b)
  PubMedGoogle Scholar
• 111 Zuravleff J J, Yu V L, Shonnard J W. et al . Diagnosis of Legionnaires’ disease. An update of laboratory methods with new emphasis on isolation by culture.  JAMA: The Journal of the American Medical Association. 1983;  250 1981-1985 (2b)
  CrossrefPubMedGoogle Scholar
• 112 Murdoch D R. Nucleic acid amplification tests for the diagnosis of pneumonia.  Clin Infect Dis. 2003;  36 1162-1170 (4)
  CrossrefPubMedGoogle Scholar
• 113 Helbig J H, Uldum S A, Bernander S. et al . Clinical utility of urinary antigen detection for diagnosis of community-acquired, travel-associated, and nosocomial legionnaires’ disease.  J Clin Microbiol. 2003;  41 838-840 (4)
  CrossrefPubMedGoogle Scholar
• 114 Dowell S F, Garman R L, Liu G. et al . Evaluation of Binax NOW, an assay for the detection of pneumococcal antigen in urine samples, performed among pediatric patients.  Clin Infect Dis. 2001;  32 824-825 (1b)
  CrossrefPubMedGoogle Scholar
• 115 Kashuba A D, Ballow C H. Legionella urinary antigen testing: potential impact on diagnosis and antibiotic therapy.  Diagn Microbiol Infect Dis. 1996;  24 129-139 (5)
  CrossrefPubMedGoogle Scholar
• 116 Wever P C, Yzerman E P, Kuijper E J. et al . Rapid diagnosis of Legionnaires’ disease using an immunochromatographic assay for Legionella pneumophila serogroup 1 antigen in urine during an outbreak in the Netherlands.  J Clin Microbiol. 2000;  38 2738-2739 (4)
  PubMedGoogle Scholar
• 117 Helbig J H, Uldum S A, Luck P C, Harrison T G. Detection of Legionella pneumophila antigen in urine samples by the BinaxNOW immunochromatographic assay and comparison with both Binax Legionella Urinary Enzyme Immunoassay (EIA) and Biotest Legionella Urin Antigen EIA.  J Med Microbiol. 2001;  50 509-516 (4)
  PubMedGoogle Scholar
• 118 Guerrero C, Toldos C M, Yague G. et al . Comparison of diagnostic sensitivities of three assays (Bartels enzyme immunoassay [EIA], Biotest EIA, and Binax NOW immunochromatographic test) for detection of Legionella pneumophila serogroup 1 antigen in urine.  J Clin Microbiol. 2004;  42 467-468 (2b)
  CrossrefPubMedGoogle Scholar
• 119 Yzerman E P, Den Boer J W, Lettinga K D. et al . Sensitivity of three urinary antigen tests associated with clinical severity in a large outbreak of Legionnaires’ disease in The Netherlands.  J Clin Microbiol. 2002;  40 3232-3236 (1b)
  CrossrefPubMedGoogle Scholar
• 120 Kessler H H, Reinthaler F F, Pschaid A. et al . Rapid detection of Legionella species in bronchoalveolar lavage fluids with the EnviroAmp Legionella PCR amplification and detection kit.  J Clin Microbiol. 1993;  31 3325-3328 (2c)
  PubMedGoogle Scholar
• 121 Weir S C, Fischer S H, Stock F, Gill V J. Detection of Legionella by PCR in respiratory specimens using a commercially available kit.  Am J Clin Pathol. 1998;  110 295-300 (2b)
  PubMedGoogle Scholar
• 122 Cloud J L, Carroll K C, Pixton P. et al . Detection of Legionella species in respiratory specimens using PCR with sequencing confirmation.  J Clin Microbiol. 2000;  38 1709-1712 (2b)
  PubMedGoogle Scholar
• 123 Murdoch D R, Anderson T P, Beynon K A. et al . Evaluation of a PCR Assay for Detection of Streptococcus pneumoniae in Respiratory and Nonrespiratory Samples from Adults with Community-Acquired Pneumonia.  J Clin Microbiol. 2003;  41 63-66 (4)
  CrossrefPubMedGoogle Scholar
• 124 Reischl U, Linde H J, Lehn N. et al . Direct detection and differentiation of Legionella spp. and Legionella pneumophila in clinical specimens by dual-color real-time PCR and melting curve analysis.  J Clin Microbiol. 2002;  40 3814-3817 (2b)
  CrossrefPubMedGoogle Scholar
• 125 Templeton K E, Scheltinga S A, Sillekens P. et al . Development and clinical evaluation of an internally controlled, single-tube multiplex real-time PCR assay for detection of Legionella pneumophila and other Legionella species.  J Clin Microbiol. 2003;  41 4016-4021 (2b)
  CrossrefPubMedGoogle Scholar
• 126 Welti M, Jaton K, Altwegg M. et al . Development of a multiplex real-time quantitative PCR assay to detect Chlamydia pneumoniae, Legionella pneumophila and Mycoplasma pneumoniae in respiratory tract secretions.  Diagn Microbiol Infect Dis. 2003;  45 85-95 (2b)
  CrossrefPubMedGoogle Scholar
• 127 Kallings I, Nordstrom K. The pattern of immunoglobulins with special reference to IgM in Legionnaires’ disease patients during a 2 year follow-up period.  Zentralbl Bakteriol Mikrobiol Hyg [A]. 1983;  255 27-32 (4)
  PubMedGoogle Scholar
• 128 Monforte R, Estruch R, Vidal J, Cervera R, Urbano-Marquez A. Delayed seroconversion in Legionnaire's disease.  Lancet. 1988;  2 513-(4)
  PubMedGoogle Scholar
• 129 Plouffe J F, File Jr T M, Breiman R F. et al . Reevaluation of the definition of Legionnaires’ disease: use of the urinary antigen assay. Community Based Pneumonia Incidence Study Group.  Clin Infect Dis. 1995;  20 1286-1291 (4)
  PubMedGoogle Scholar
• 130 Boswell T C, Marshall L E, Kudesia G. False-positive legionella titres in routine clinical serology testing detected by absorption with campylobacter: implications for the serological diagnosis of legionnaires’ disease.  J Infect. 1996;  32 23-26 (4)
  CrossrefPubMedGoogle Scholar
• 131 Musso D, Raoult D. Serological cross-reactions between Coxiella burnetii and Legionella micdadei.  Clin Diagn Lab Immunol. 1997;  4 208-212 (4)
  CrossrefPubMedGoogle Scholar
• 132 Waterer G W, Baselski V S, Wunderink R G. Legionella and community-acquired pneumonia: a review of current diagnostic tests from a clinician’s viewpoint.  Am J Med. 2001;  110 41-48 (5)
  CrossrefPubMedGoogle Scholar
• 133 Ieven M, Goossens H. Relevance of nucleic acid amplification techniques for diagnosis of respiratory tract infections in the clinical laboratory.  Clin Microbiol Rev. 1997;  10 242-256 (5)
  PubMedGoogle Scholar
• 134 Ponka A, Ponka T, Sarna S, Penttinen K. Questionable specificity of lipid antigen in the Mycoplasma pneumoniae complement fixation test in patients with extrapulmonary manifestations.  J Infect. 1981;  3 332-338 (4)
  CrossrefPubMedGoogle Scholar
• 135 Ruuskanen O, Nohynek H, Ziegler T. et al . Pneumonia in childhood: etiology and response to antimicrobial therapy.  Eur J Clin Microbiol Infect Dis. 1992;  11 217-223 (4)
  CrossrefPubMedGoogle Scholar
• 136 Taylor-Robinson D. Infections due to species of Mycoplasma and Ureaplasma: an update.  Clin Infect Dis. 1996;  23 671-682 (5)
  PubMedGoogle Scholar
• 137 Watkins-Riedel T, Stanek G, Daxboeck F. Comparison of SeroMP IgA with four other commercial assays for serodiagnosis of Mycoplasma pneumoniae pneumonia.  Diagn Microbiol Infect Dis. 2001;  40 21-25 (1b)
  CrossrefPubMedGoogle Scholar
• 138 Schmidt-Ioanas M, Bender M, Roth A. et al . Serologic early diagnosis of pneumonia caused by Mycoplasma pneumoniae.  Dtsch Med Wochenschr. 2006;  131 613-617 (2b)
  Article in Thieme ConnectPubMedGoogle Scholar
• 139 Stralin K, Holmberg H. Usefulness of the Streptococcus pneumoniae urinary antigen test in the treatment of community-acquired pneumonia.  Clin Infect Dis. 2005;  41 1209-1210 (2b)
  CrossrefPubMedGoogle Scholar
• 140 Ieven M, Ursi D, Van Bever H. et al . Detection of Mycoplasma pneumoniae by two polymerase chain reactions and role of M. pneumoniae in acute respiratory tract infections in pediatric patients.  J Infect Dis. 1996;  173 1445-1452 (2b)
  CrossrefPubMedGoogle Scholar
• 141 Abele-Horn M, Busch U, Nitschko H. et al . Molecular approaches to diagnosis of pulmonary diseases due to Mycoplasma pneumoniae.  J Clin Microbiol. 1998;  36 548-551 (2b)
  PubMedGoogle Scholar
• 142 Dorigo-Zetsma J W, Zaat S A, Wertheim-van Dillen P M. et al . Comparison of PCR, culture, and serological tests for diagnosis of Mycoplasma pneumoniae respiratory tract infection in children.  J Clin Microbiol. 1999;  37 14-17 (2b)
  PubMedGoogle Scholar
• 143 Dorigo-Zetsma J W, Verkooyen R P, van Helden H P. et al . Molecular detection of Mycoplasma pneumoniae in adults with community-acquired pneumonia requiring hospitalization.  J Clin Microbiol. 2001;  39 1184-1186 (4)
  CrossrefPubMedGoogle Scholar
• 144 Loens K, Ieven M, Ursi D. et al . Detection of Mycoplasma pneumoniae by real-time nucleic acid sequence-based amplification.  J Clin Microbiol. 2003;  41 4448-4450 (2b)
  CrossrefPubMedGoogle Scholar
• 145 Ursi D, Dirven K, Loens K. et al . Detection of Mycoplasma pneumoniae in respiratory samples by real-time PCR using an inhibition control.  J Microbiol Methods. 2003;  55 149-153 (2b)
  CrossrefPubMedGoogle Scholar
• 146 Templeton K E, Scheltinga S A, Graffelman A W. et al . Comparison and evaluation of real-time PCR, real-time nucleic acid sequence-based amplification, conventional PCR, and serology for diagnosis of Mycoplasma pneumoniae.  J Clin Microbiol. 2003;  41 4366-4371
  CrossrefPubMedGoogle Scholar
• 147 Loens K, Ursi D, Goossens H, Ieven M. Molecular diagnosis of Mycoplasma pneumoniae respiratory tract infections.  J Clin Microbiol. 2003;  41 4915-4923 (5)
  CrossrefPubMedGoogle Scholar
• 148 Ortiz-Ruiz G, Vetter N, Isaacs R. et al . Ertapenem versus ceftriaxone for the treatment of community-acquired pneumonia in adults: combined analysis of two multicentre randomized, double-blind studies.  J Antimicrob Chemother. 2004;  53 (Suppl. 2) ii59-ii66 (1b)
  CrossrefPubMedGoogle Scholar
• 149 Tompkins L S, Schachter J, Boman J. et al . Collaborative multidisciplinary workshop report: detection, culture, serology, and antimicrobial susceptibility testing of Chlamydia pneumoniae.  J Infect Dis. 2000;  181 (Suppl. 3) S460-S461 (5)
  CrossrefPubMedGoogle Scholar
• 150 Mandell L A, Bartlett J G, Dowell S F. et al . Update of practice guidelines for the management of community-acquired pneumonia in immunocompetent adults.  Clin Infect Dis. 2003;  37 1405-1433 (5)
  CrossrefPubMedGoogle Scholar
• 151 Dowell S F, Peeling R W, Boman J. et al . Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada).  Clin Infect Dis. 2001;  33 492-503 (5)
  CrossrefPubMedGoogle Scholar
• 152 Dowell J, Pitkethly M, Bain J, Martin S. A randomised controlled trial of delayed antibiotic prescribing as a strategy for managing uncomplicated respiratory tract infection in primary care.  Br J Gen Pract. 2001;  51 200-205 (1b)
  PubMedGoogle Scholar
• 153 Reischl U, Lehn N, Simnacher U. et al . Rapid and standardized detection of Chlamydia pneumoniae using LightCycler real-time fluorescence PCR.  Eur J Clin Microbiol Infect Dis. 2003;  22 54-57 (2b)
  PubMedGoogle Scholar
• 154 Bartlett J G, Breiman R F, Mandell L A, File Jr T M. Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults.  Clin Infect Dis. 1998;  26 811-838 (5)
  CrossrefPubMedGoogle Scholar
• 155 Steininger C, Kundi M, Aberle S W. et al . Effectiveness of reverse transcription-PCR, virus isolation, and enzyme-linked immunosorbent assay for diagnosis of influenza A virus infection in different age groups.  J Clin Microbiol. 2002;  40 2051-2056 (2b)
  CrossrefPubMedGoogle Scholar
• 156 Mahony J B. Detection of respiratory viruses by molecular methods.  Clin Microbiol Rev. 2008;  21 716-747 (5)
  CrossrefPubMedGoogle Scholar
• 157 Schrag S J, Pena C, Fernandez J. et al . Effect of short-course, high-dose amoxicillin therapy on resistant pneumococcal carriage: a randomized trial.  JAMA. 2001;  286 49-56 (1b)
  CrossrefPubMedGoogle Scholar
• 158 Pepin J, Saheb N, Coulombe M A. et al . Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec.  Clin Infect Dis. 2005;  41 1254-1260 (2c)
  CrossrefPubMedGoogle Scholar
• 159 Dhalla I A, Mamdani M M, Simor A E. et al . Are broad-spectrum fluoroquinolones more likely to cause Clostridium difficile-associated disease?.  Antimicrob Agents Chemother. 2006;  50 3216-3219 (3b)
  CrossrefPubMedGoogle Scholar
• 160 Loo V G, Poirier L, Miller M A. et al . A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality.  N Engl J Med. 2005;  353 2442-2449 (3b)
  CrossrefPubMedGoogle Scholar
• 161 Diehr P, Wood R W, Bushyhead J. et al . Prediction of pneumonia in outpatients with acute cough – a statistical approach.  J Chronic Dis. 1984;  37 215-225 (4)
  CrossrefPubMedGoogle Scholar
• 162 Gennis P, Gallagher J, Falvo C. et al . Clinical criteria for the detection of pneumonia in adults: guidelines for ordering chest roentgenograms in the emergency department.  J Emerg Med. 1989;  7 263-268 (4)
  CrossrefPubMedGoogle Scholar
• 163 Heckerling P S, Tape T G, Wigton R S. et al . Clinical prediction rule for pulmonary infiltrates.  Ann Intern Med. 1990;  113 664-670 (4)
  CrossrefPubMedGoogle Scholar
• 164 Melbye H, Straume B, Aasebo U, Dale K. Diagnosis of pneumonia in adults in general practice. Relative importance of typical symptoms and abnormal chest signs evaluated against a radiographic reference standard.  Scand J Prim Health Care. 1992;  10 226-233 (2b)
  CrossrefPubMedGoogle Scholar
• 165 Metlay J P, Kapoor W N, Fine M J. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination.  JAMA. 1997;  278 1440-1445 (5)
  CrossrefPubMedGoogle Scholar
• 166 Wipf J E, Lipsky B A, Hirschmann J V. et al . Diagnosing pneumonia by physical examination: relevant or relic?.  Arch Intern Med. 1999;  159 1082-1087 (2b)
  CrossrefPubMedGoogle Scholar
• 167 Schilling R S, Hughes J P, Dingwall-Fordyce I. Disagreement between observers in an epidemiological study of respiratory disease.  Br Med J. 1955;  4905 65-68 (4)
  PubMedGoogle Scholar
• 168 Spiteri M A, Cook D G, Clarke S W. Reliability of eliciting physical signs in examination of the chest.  Lancet. 1988;  1 873-875 (2b)
  PubMedGoogle Scholar
• 169 Emerman C L, Dawson N, Speroff T. et al . Comparison of physician judgment and decision aids for ordering chest radiographs for pneumonia in outpatients.  Ann Emerg Med. 1991;  20 1215-1219 (4)
  CrossrefPubMedGoogle Scholar
• 170 Heckerling P S. The need for chest roentgenograms in adults with acute respiratory illness. Clinical predictors.  Arch Intern Med. 1986;  146 1321-1324 (4)
  CrossrefPubMedGoogle Scholar
• 171 Metlay J P, Schulz R, Li Y H. et al . Influence of age on symptoms at presentation in patients with community-acquired pneumonia.  Arch Intern Med. 1997;  157 1453-1459 (2c)
  CrossrefPubMedGoogle Scholar
• 172 Melbye H, Dale K. Interobserver variability in the radiographic diagnosis of adult outpatient pneumonia.  Acta Radiol. 1992;  33 79-81 (2b)
  CrossrefPubMedGoogle Scholar
• 173 Young M, Marrie T J. Interobserver variability in the interpretation of chest roentgenograms of patients with possible pneumonia.  Arch Intern Med. 1994;  154 2729-2732 (2b)
  CrossrefPubMedGoogle Scholar
• 174 Speets A M, Hoes A W, van der Graaf Y. et al . Chest radiography and pneumonia in primary care: diagnostic yield and consequences for patient management.  Eur Respir J. 2006;  28 933-938 (2b)
  CrossrefPubMedGoogle Scholar
• 175 Falguera M, Martin M, Ruiz-Gonzalez A. et al . Community-acquired pneumonia as the initial manifestation of serious underlying diseases.  Am J Med. 2005;  118 378-383 (3b)
  CrossrefPubMedGoogle Scholar
• 176 Altiner A, Haag H, Schraven C. et al . Akuter Husten: Was erwarten die Patienten?.  Z Allg Med. 2002;  78 19-23 (4)
  PubMedGoogle Scholar
• 177 van Driel M L, De S A, Deveugele M. et al . Are sore throat patients who hope for antibiotics actually asking for pain relief?.  Ann Fam Med. 2006;  4 494-499 (2c)
  CrossrefPubMedGoogle Scholar
• 178 Little P, Rumsby K, Kelly J. et al . Information leaflet and antibiotic prescribing strategies for acute lower respiratory tract infection: a randomized controlled trial.  JAMA. 2005;  293 3029-3035 (1b)
  CrossrefPubMedGoogle Scholar
• 179 Altiner A, Brockmann S, Sielk M. et al . Reducing antibiotic prescriptions for acute cough by motivating GPs to change their attitudes to communication and empowering patients: a cluster-randomized intervention study.  J Antimicrob Chemother. 2007;  60 638-644 (1b)
  CrossrefPubMedGoogle Scholar
• 180 Johnston S L, Blasi F, Black P N. et al . The effect of telithromycin in acute exacerbations of asthma.  N Engl J Med. 2006;  354 1589-1600 (1b)
  CrossrefPubMedGoogle Scholar
• 181 Fahey T, Stocks N, Thomas T. Quantitative systematic review of randomised controlled trials comparing antibiotic with placebo for acute cough in adults.  BMJ. 1998;  316 906-910 (1a)
  CrossrefPubMedGoogle Scholar
• 182 Gonzales R, Steiner J F, Sande M A. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians.  JAMA. 1997;  278 901-904 (2c)
  CrossrefPubMedGoogle Scholar
• 183 Gonzales R, Steiner J F, Lum A, Barrett Jr P H. Decreasing antibiotic use in ambulatory practice: impact of a multidimensional intervention on the treatment of uncomplicated acute bronchitis in adults.  JAMA. 1999;  281 1512-1519 (2b)
  CrossrefPubMedGoogle Scholar
• 184 Hayden F G, Osterhaus A D, Treanor J J. et al . Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenzavirus infections. GG167 Influenza Study Group.  N Engl J Med. 1997;  337 874-880 (1b)
  CrossrefPubMedGoogle Scholar
• 185 Monto A S, Fleming D M, Henry D. et al . Efficacy and safety of the neuraminidase inhibitor zanamivirin the treatment of influenza A and B virus infections.  J Infect Dis. 1999;  180 254-261 (1b)
  CrossrefPubMedGoogle Scholar
• 186 Treanor J J, Hayden F G, Vrooman P S. et al . Efficacy and safety of the oral neuraminidase inhibitor oseltamivir in treating acute influenza: a randomized controlled trial. US Oral Neuraminidase Study Group.  JAMA. 2000;  283 1016-1024 (1b)
  CrossrefPubMedGoogle Scholar
• 187 Nicholson K G, Aoki F Y, Osterhaus A D. et al . Efficacy and safety of oseltamivir in treatment of acute influenza: a randomised controlled trial. Neuraminidase Inhibitor Flu Treatment Investigator Group.  Lancet. 2000;  355 1845-1850 (1b)
  CrossrefPubMedGoogle Scholar
• 188 Monto A S, Webster A, Keene O. Randomized, placebo-controlled studies of inhaled zanamivir in the treatment of influenza A and B: pooled efficacy analysis.  J Antimicrob Chemother. 1999;  44 (Suppl. B) 23-29 (1a)
  CrossrefPubMedGoogle Scholar
• 189 McGeer A, Green K A, Plevneshi A. et al . Antiviral therapy and outcomes of influenza requiring hospitalization in Ontario, Canada.  Clin Infect Dis. 2007;  45 1568-1575 (2c)
  CrossrefPubMedGoogle Scholar
• 190 Ohmit S E, Moler F W, Monto A S, Khan A S. Ribavirin utilization and clinical effectiveness in children hospitalized with respiratory syncytial virus infection.  J Clin Epidemiol. 1996;  49 963-967 (2c)
  CrossrefPubMedGoogle Scholar
• 191 Anthonisen N R, Manfreda J, Warren C PW. et al . Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease.  Ann Intern Med. 1987;  106 196-204 (2b)
  CrossrefPubMedGoogle Scholar
• 192 Stockley R A, O’Brien C, Pye A, Hill S L. Relationship of sputum color to nature and outpatient management of acute exacerbations of COPD.  Chest. 2000;  117 1638-1645 (2b)
  CrossrefPubMedGoogle Scholar
• 193 Seemungal T, Harper-Owen R, Bhowmik A. et al . Respiratory Viruses, Symptoms, and Inflammatory Markers in Acute Exacerbations and Stable Chronic Obstructive Pulmonary Disease.  Am J Respir Crit Care Med. 2001;  164 1618-1623 (2b)
  CrossrefPubMedGoogle Scholar
• 194 Rohde G, Wiethege A, Borg I. et al . Respiratory viruses in exacerbations of chronic obstructive pulmonary disease requiring hospitalization – a case-control study.  Thorax. 2003;  58 37-42 (2b)
  CrossrefPubMedGoogle Scholar
• 195 Papi A, Bellettato C M, Braccioni F. et al . Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations.  Am J Respir Crit Care Med. 2006;  173 1114-1121 (2c)
  CrossrefPubMedGoogle Scholar
• 196 Wedzicha J A. Role of viruses in exacerbations of chronic obstructive pulmonary disease.  Proc Am Thorac Soc. 2004;  1 115-120 (5)
  CrossrefPubMedGoogle Scholar
• 197 Sethi S, Evans N, Grant B J, Murphy T F. New strains of bacteria and exacerbations of chronic obstructive pulmonary disease.  N Engl J Med. 2002;  347 465-471 (3b)
  CrossrefPubMedGoogle Scholar
• 198 Sethi S, Wrona C, Grant B J, Murphy T F. Strain-specific immune response to Haemophilus influenzae in chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 2004;  169 448-453 (4)
  PubMedGoogle Scholar
• 199 Sethi S, Wrona C, Eschberger K. et al . Inflammatory profile of new bacterial strain exacerbations of chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 2008;  177 491-497 (2c)
  PubMedGoogle Scholar
• 200 Sethi S, Sethi R, Eschberger K. et al . Airway bacterial concentrations and exacerbations of chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 2007;  176 356-361 (4)
  CrossrefPubMedGoogle Scholar
• 201 Chodosh S, McCarty J, Farkas S. et al . Randomized, double-blind study of ciprofloxacin and cefuroxime axetil for treatment of acute bacterial exacerbations of chronic bronchitis. The Bronchitis Study Group.  Clin Infect Dis. 1998;  27 722-729 (1b)
  CrossrefPubMedGoogle Scholar
• 202 Angrill J, Agusti C, de Celis R. et al . Bacterial colonisation in patients with bronchiectasis: microbiological pattern and risk factors.  Thorax. 2002;  57 15-19 (2b)
  CrossrefPubMedGoogle Scholar
• 203 Eller J, Ede A, Schaberg T. et al . Infective exacerbations of chronic bronchitis: relation betwen bacteriologic etiology and lung function.  Chest. 1998;  113 1542-1548 (4)
  CrossrefPubMedGoogle Scholar
• 204 Miravitlles M, Espinosa C, Fernandez-Laso E. et al . Relationship between bacterial flora in sputum and functional impairment in patients with acute exacerbations of COPD. Study Group of Bacterial Infection in COPD.  Chest. 1999;  116 40-46 (2c)
  CrossrefPubMedGoogle Scholar
• 205 Anzueto A, Niederman M S, Tillotson G S. Etiology, susceptibility, and treatment of acute bacterial exacerbations of complicated chronic bronchitis in the primary care setting: ciprofloxacin 750 mg b. i. d. versus clarithromycin 500 mg b. i. d. Bronchitis Study Group.  Clin Ther. 1998;  20 885-900 (1b)
  CrossrefPubMedGoogle Scholar
• 206 Fagon J Y, Chastre J, Trouillet J L. et al . Characterization of distal bronchial microflora during acute exacerbation of chronic bronchitis. Use of the protected specimen brush technique in 54 mechanically ventilated patients.  Am Rev Respir Dis. 1990;  142 1004-1008 (4)
  PubMedGoogle Scholar
• 207 Soler N, Torres A, Ewig S. et al . Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation.  Am J Respir Crit Care Med. 1998;  157 1498-1505 (3b)
  CrossrefPubMedGoogle Scholar
• 208 Blasi F, Damato S, Cosentini R. et al. . Chlamydia pneumoniae and chronic bronchitis: association with severity and bacterial clearance following treatment.  Thorax. 2002;  57 672-676 (5)
  CrossrefPubMedGoogle Scholar
• 209 Blasi F, Legnani D, Lombardo V M. et al . Chlamydia pneumoniae infection in acute exacerbations of COPD.  Eur Respir J. 1993;  6 19-22 (3b)
  PubMedGoogle Scholar
• 210 Buscho R O, Saxtan D, Shultz P S. et al . Infections with viruses and Mycoplasma pneumoniae during exacerbations of chronic bronchitis.  J Infect Dis. 1978;  137 377-383 (4)
  CrossrefPubMedGoogle Scholar
• 211 Mogulkoc N, Karakurt S, Isalska B. et al . Acute purulent exacerbation of chronic obstructive pulmonary disease and Chlamydia pneumoniae infection.  Am J Respir Crit Care Med. 1999;  160 349-353 (3b)
  PubMedGoogle Scholar
• 212 Lieberman D, Lieberman D, Shmarkov O. et al . Serological evidence of Legionella species infection in acute exacerbation of COPD.  Eur Respir J. 2002;  19 392-397 (3b)
  CrossrefPubMedGoogle Scholar
• 213 Kessler R, Faller M, Fourgaut G. et al . Predictive factors of hospitalization for acute exacerbation in a series of 64 patients with chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 1999;  159 158-164 (2c)
  CrossrefPubMedGoogle Scholar
• 214 Anon J M, Garcia D L, Zarazaga A. et al . Mechanical ventilation of patients on long-term oxygen therapy with acute exacerbations of chronic obstructive pulmonary disease: prognosis and cost-utility analysis.  Intensive Care Med. 1999;  25 452-457 (4)
  CrossrefPubMedGoogle Scholar
• 215 Chu C M, Chan V L, Lin A WN. et al . Readmission rates and life threatening events in COPD survivors treated with non-invasive ventilation for acute hypercapnic respiratory failure.  Thorax. 2004;  59 1020-1025 (2c)
  CrossrefPubMedGoogle Scholar
• 216 Groenewegen K H, Schols A MWJ, Wouters E FM. Mortality and Mortality-Related Factors After Hospitalization for Acute Exacerbation of COPD.  Chest. 2003;  124 459-467 (2c)
  CrossrefPubMedGoogle Scholar
• 217 Patil S P, Krishnan J A, Lechtzin N, Diette G B. In-hospital mortality following acute exacerbations of chronic obstructive pulmonary disease.  Arch Intern Med. 2003;  163 1180-1186 (2c)
  CrossrefPubMedGoogle Scholar
• 218 Ferrer M, Ioanas M, Arancibia F. et al . Microbial airway colonization is associated with noninvasive ventilation failure in exacerbation of chronic obstructive pulmonary disease.  Crit Care Med. 2005;  33 2003-2009 (3b)
  CrossrefPubMedGoogle Scholar
• 219 Donaldson G C, Seemungal T A, Bhowmik A, Wedzicha J A. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease.  Thorax. 2002;  57 847-852 (3b)
  CrossrefPubMedGoogle Scholar
• 220 Wilkinson T MA, Patel I S, Wilks M. et al . Airway Bacterial Load and FEV1 Decline in Patients with Chronic Obstructive Pulmonary Disease.  Am J Respir Crit Care Med. 2003;  167 1090 (3b)
  PubMedGoogle Scholar
• 221 Stolz D, Christ-Crain M, Bingisser R. et al . Antibiotic treatment of exacerbations of COPD: a randomized, controlled trial comparing procalcitonin-guidance with standard therapy.  Chest. 2007;  131 9-19 (1b)
  CrossrefPubMedGoogle Scholar
• 222 Christ-Crain M, Jaccard-Stolz D, Bingisser R. et al . Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial.  Lancet. 2004;  363 600-607 (2b)
  CrossrefPubMedGoogle Scholar
• 223 Nicotra M B, Rivera M, Awe R J. Antibiotic therapy of acute exacerbations of chronic bronchitis. A controlled study using tetracycline.  Ann Intern Med. 1982;  97 18-21 (1b)
  PubMedGoogle Scholar
• 224 Nouira S, Marghli S, Belghith M. et al . Once daily oral ofloxacin in chronic obstructive pulmonary disease exacerbation requiring mechanical ventilation: a randomised placebo-controlled trial.  Lancet. 2001;  358 2020-2025 (1b)
  CrossrefPubMedGoogle Scholar
• 225 Sachs A P, Koeter G H, Groenier K H. et al . Changes in symptoms, peak expiratory flow, and sputum flora during treatment with antibiotics of exacerbations in patients with chronic obstructive pulmonary disease in general practice.  Thorax. 1995;  50 758-763 (1b)
  CrossrefPubMedGoogle Scholar
• 226 Jorgensen A F, Coolidge J, Pedersen P A. et al . Amoxicillin in treatment of acute uncomplicated exacerbations of chronic bronchitis. A double-blind, placebo-controlled multicentre study in general practice.  Scand J Prim Health Care. 1992;  10 7-11 (1b)
  CrossrefPubMedGoogle Scholar
• 227 Ram F S, Rodriguez-Roisin R, Granados-Navarrete A. et al . Antibiotics for exacerbations of chronic obstructive pulmonary disease.  Cochrane Database Syst Rev. 2006;  CD004403 (1a)
  PubMedGoogle Scholar
• 228 Soler N, Agusti C, Angrill J. et al . Bronchoscopic validation of the significance of sputum purulence in severe exacerbations of chronic obstructive pulmonary disease.  Thorax. 2007;  62 29-35 (2b)
  CrossrefPubMedGoogle Scholar
• 229 Chodosh S, Schreurs A, Siami G. et al . Efficacy of oral ciprofloxacin vs. clarithromycin for treatment of acute bacterial exacerbations of chronic bronchitis. The Bronchitis Study Group.  Clin Infect Dis. 1998;  27 730-738 (1b)
  CrossrefPubMedGoogle Scholar
• 230 Adams S G, Melo J, Luther M, Anzueto A. Antibiotics are associated with lower relapse rates in outpatients with acute exacerbations of COPD.  Chest. 2000;  117 1345-1352 (4)
  CrossrefPubMedGoogle Scholar
• 231 Wilson R, Schentag J J, Ball P, Mandell L. A comparison of gemifloxacin and clarithromycin in acute exacerbations of chronic bronchitis and long-term clinical outcomes.  Clin Ther. 2002;  24 639-652 (1b)
  CrossrefPubMedGoogle Scholar
• 232 Wilson R, Allegra L, Huchon G. et al . Short-term and Long-term Outcomes of Moxifloxacin Compared to Standard Antibiotic Treatment in Acute Exacerbations of Chronic Bronchitis.  Chest. 2004;  125 953-964 (1b)
  CrossrefPubMedGoogle Scholar
• 233 Murphy T F, Brauer A L, Eschberger K. et al . Pseudomonas aeruginosa in chronic obstructive pulmonary disease.  Am J Respir Crit Care Med. 2008;  177 853-860 (4)
  CrossrefPubMedGoogle Scholar
• 234 Zhanel G G, Ennis K, Vercaigne L. et al . A critical review of the fluoroquinolones: focus on respiratory infections.  Drugs. 2002;  62 13-59 (5)
  CrossrefPubMedGoogle Scholar
• 235 Neuhauser M M, Weinstein R A, Rydman R. et al . Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use.  JAMA. 2003;  289 885-888 (4)
  CrossrefPubMedGoogle Scholar
• 236 Drobnic M E, Sune P, Montoro J B. et al . Inhaled Tobramycin in Non-Cystic Fibrosis Patients with Bronchiectasis and Chronic Bronchial Infection with Pseudomonas aeruginosa.  The Annals of Pharmacotherapy. 2005;  39 39-44 (1b)
  CrossrefPubMedGoogle Scholar
• 237 Barker A F, Couch L, Fiel S B. et al . Tobramycin solution for inhalation reduces sputum Pseudomonas aeruginosa density in bronchiectasis.  Am J Respir Crit Care Med. 2000;  162 481-485 (1b)
  CrossrefPubMedGoogle Scholar
• 238 Zervos M J, Heyder A M, Leroy B. Oral telithromycin 800 mg once daily for 5 days versus cefuroxime axetil 500 mg twice daily for 10 days in adults with acute exacerbations of chronic bronchitis.  J Int Med Res. 2003;  31 157-169 (1b)
  PubMedGoogle Scholar
• 239 Masterton R G, Burley C J. Randomized, double-blind study comparing 5- and 7-day regimens of oral levofloxacin in patients with acute exacerbation of chronic bronchitis.  Int J Antimicrob Agents. 2001;  18 503-512 (1b)
  CrossrefPubMedGoogle Scholar
• 240 Schonhofer B, Kohler D. Prevalence of deep-vein thrombosis of the leg in patients with acute exacerbation of chronic obstructive pulmonary disease.  Respiration. 1998;  65 173-177 (4)
  CrossrefPubMedGoogle Scholar
• 241 Lim W S, van der Eerden M M, Laing R. et al . Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study.  Thorax. 2003;  58 377-382 (2c)
  CrossrefPubMedGoogle Scholar
• 242 Lim W S, Lewis S, Macfarlane J T. Severity prediction rules in community acquired pneumonia: a validation study.  Thorax. 2000;  55 219-223 (3b)
  CrossrefPubMedGoogle Scholar
• 243 British Thoracic Society and the Public Health Laboratory Service . Community-acquired pneumonia in adults in British hospitals in 1982 – 1983: A survey of aetiology, mortality, prognostic factors and outcome.  Q J Med. 1987;  62 195-200 (2c)
  PubMedGoogle Scholar
• 244 Neill A M, Martin I R, Weir R. et al . Community-acquired pneumonia: aetiology and usefulness of severity criteria on admission.  Thorax. 1996;  51 1010-1016 (4)
  CrossrefPubMedGoogle Scholar
• 245 Capelastegui A, Espana P P, Quintana J M. et al . Validation of a predictive rule for the management of community-acquired pneumonia.  Eur Respir J. 2006;  27 151-157 (2b)
  CrossrefPubMedGoogle Scholar
• 246 Ewig S, Kleinfeld T, Bauer T T. et al . Comparative validation of prognostic rules for community-acquired pneumonia in an elderly population.  Eur Respir J. 1999;  14 370-375 (4)
  PubMedGoogle Scholar
• 247 Ewig S, de Roux A, Bauer T. et al . Validation of predictive rules and indices of severity for community acquired pneumonia.  Thorax. 2004;  59 421-427 (4)
  CrossrefPubMedGoogle Scholar
• 248 Yan M S, Lee N, Ip M. et al . Prospective comparison of three predictive rules for assessing severity of community-acquired pneumonia in Hong Kong.  Thorax. 2007;  62 348-353 (2c)
  CrossrefPubMedGoogle Scholar
• 249 Ewig S, Ruiz M, Mensa J. et al . Severe community-acquired pneumonia: Assessment of severity criteria.  Am J Respir Crit Care Med. 1998;  158 1102-1108 (4)
  CrossrefPubMedGoogle Scholar
• 250 Angus D C, Marrie T J, Obrosky D S. et al . Severe community-acquired pneumonia: use of intensive care services and evaluation of American and British Thoracic Society Diagnostic criteria.  Am J Respir Crit Care Med. 2002;  166 717-723 (2b)
  CrossrefPubMedGoogle Scholar
• 251 Espana P P, Capelastegui A, Gorordo I. et al . Development and validation of a clinical prediction rule for severe community-acquired pneumonia.  Am J Respir Crit Care Med. 2006;  174 1249-1256 (2c)
  CrossrefPubMedGoogle Scholar
• 252 Mandell L A, Wunderink R G, Anzueto A. et al . Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults.  Clinical Infectious Diseases. 2007;  44 S27-S72 (5)
  CrossrefPubMedGoogle Scholar
• 253 Rivers E, Nguyen B, Havstad S. et al . Early goal-directed therapy in the treatment of severe sepsis and septic shock.  N Engl J Med. 2001;  345 1368-1377 (1b)
  CrossrefPubMedGoogle Scholar
• 254 Mansel J K, Rosenow III E C, Smith T F, Martin Jr J W. Mycoplasma pneumoniae pneumonia.  Chest. 1989;  95 639-646 (4)
  CrossrefPubMedGoogle Scholar
• 255 Petitpretz P, Arvis P, Marel M. et al . Oral moxifloxacin vs. high-dosage amoxicillin in the treatment of mild-to-moderate, community-acquired, suspected pneumococcal pneumonia in adults.  Chest. 2001;  119 185-195 (1b)
  CrossrefPubMedGoogle Scholar
• 256 Petitpretz P, Chidiac C, Soriano F. et al . The efficacy and safety of oral pharmacokinetically enhanced amoxycillin-clavulanate 2000/125 mg, twice daily, versus oral amoxycillin-clavulanate 1000/125 mg, three times daily, for the treatment of bacterial community-acquired pneumonia in adults.  Int J Antimicrob Agents. 2002;  20 119-129 (1b)
  CrossrefPubMedGoogle Scholar
• 257 Mills G D, Oehley M R, Arrol B. Effectiveness of beta lactam antibiotics compared with antibiotics active against atypical pathogens in non-severe community acquired pneumonia: meta-analysis.  BMJ. 2005;  330 456 (1a)
  PubMedGoogle Scholar
• 258 Shefet D, Robenshtok E, Paul M, Leibovici L. Empirical atypical coverage for inpatients with community-acquired pneumonia: systematic review of randomized controlled trials.  Arch Intern Med. 2005;  165 1992-2000 (1a)
  CrossrefPubMedGoogle Scholar
• 259 Tellier G, Niederman M S, Nusrat R. et al . Clinical and bacteriological efficacy and safety of 5 and 7 day regimens of telithromycin once daily compared with a 10 day regimen of clarithromycin twice daily in patients with mild to moderate community-acquired pneumonia.  J Antimicrob Chemother. 2004;  54 515-523 (1b)
  CrossrefPubMedGoogle Scholar
• 260 Ailani R K, Agastya G, Ailani R K. et al . Doxycycline is a cost-effective therapy for hospitalized patients with community-acquired pneumonia.  Arch Intern Med. 1999;  159 266-270 (2b)
  CrossrefPubMedGoogle Scholar
• 261 Gordon J J, Kauffman C A. Superinfection with Streptococcus pneumoniae during therapy with ciprofloxacin.  Am J Med. 1990;  89 383-384 (5)
  CrossrefPubMedGoogle Scholar
• 262 Kuru T, Lyons 3 J P. Nonresolving or slowly resolving pneumonia.  Clin Chest Med. 1999;  20 623-651 (4)
  CrossrefPubMedGoogle Scholar
• 263 Dunbar L M, Wunderink R G, Habib M P. et al . High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm.  Clin Infect Dis. 2003;  37 752-760 (1b)
  CrossrefPubMedGoogle Scholar
• 264 El Moussaoui R, de Borgie C A, van den Broek P. et al . Effectiveness of discontinuing antibiotic treatment after three days versus eight days in mild to moderate-severe community acquired pneumonia: randomised, double blind study.  BMJ. 2006;  332 1355 (1b)
  PubMedGoogle Scholar
• 265 Li J Z, Winston L G, Moore D H, Bent S. Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis.  Am J Med. 2007;  120 783-790 (1a)
  CrossrefPubMedGoogle Scholar
• 266 Campbell S G, Marrie T J, Anstey R. et al . The Contribution of Blood Cultures to the Clinical Management of Adult Patients Admitted to the Hospital With Community-Acquired Pneumonia: A Prospective Observational Study.  Chest. 2003;  123 1142-1150 (1b)
  CrossrefPubMedGoogle Scholar
• 267 Lode H, Magyar P, Muir J F. et al . Once-daily oral gatifloxacin vs three-times-daily co-amoxiclav in the treatment of patients with community-acquired pneumonia.  Clin Microbiol Infect. 2004;  10 512-520 (1b)
  CrossrefPubMedGoogle Scholar
• 268 Okimoto N, Kurihara T, Honda N. et al . Clinical effect of ampicillin with beta-lactamase inhibitor (sulbactam/ampicillin) on community-acquired pneumonia in the elderly.  J Infect Chemother. 2003;  9 183-186 (2b)
  PubMedGoogle Scholar
• 269 File Jr T M, Segreti J, Dunbar L. et al . A multicenter, randomized study comparing the efficacy and safety of intravenous and/or oral levofloxacin versus ceftriaxone and/or cefuroxime axetil in treatment of adults with community-acquired pneumonia.  Antimicrob Agents Chemother. 1997;  41 1965-1972 (1b)
  PubMedGoogle Scholar
• 270 Gotfried M H, Dattani D, Riffer E. et al . A controlled, double-blind, multicenter study comparing clarithromycin extended-release tablets and levofloxacin tablets in the treatment of community-acquired pneumonia.  Clin Ther. 2002;  24 736-751 (1b)
  CrossrefPubMedGoogle Scholar
• 271 Hoeffken G, Meyer H P, Winter J, Verhoef L. The efficacy and safety of two oral moxifloxacin regimens compared to oral clarithromycin in the treatment of community-acquired pneumonia.  Respir Med. 2001;  95 553-564 (1b)
  CrossrefPubMedGoogle Scholar
• 272 Scheld W M. Maintaining fluoroquinolone class efficacy: review of influencing factors.  Emerg Infect Dis. 2003;  9 1-9 (5)
  PubMedGoogle Scholar
• 273 Zuck P, Rio Y, Ichou F. Efficacy and tolerance of cefpodoxime proxetil compared with ceftriaxone in vulnerable patients with bronchopneumonia.  J Antimicrob Chemother. 1990;  26 (Suppl. E) 71-77 (2b)
  CrossrefPubMedGoogle Scholar
• 274 Paladino J A, Eubanks D A, Adelman M H, Schentag J J. Once-daily cefepime versus ceftriaxone for nursing home-acquired pneumonia.  J Am Geriatr Soc. 2007;  55 651-657 (1b)
  CrossrefPubMedGoogle Scholar
• 275 Bohte R, van Furth R, van den Broek P J. Aetiology of community-acquired pneumonia: a prospective study among adults requiring admission to hospital.  Thorax. 1995;  50 543-547 (4)
  CrossrefPubMedGoogle Scholar
• 276 Fine M J, Stone R A, Singer D E. et al . Processes and outcomes of care for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team (PORT) cohort study.  Arch Intern Med. 1999;  159 970-980 (4)
  CrossrefPubMedGoogle Scholar
• 277 Allewelt M, Steinhoff D, Rahlwes M. et al . Wandel im Erregerspektrum ambulant-erworbener Pneumonien (1982 – 1992).  Dtsch Med Wochenschr. 1997;  122 1027-1032 (4)
  Article in Thieme ConnectPubMedGoogle Scholar
• 278 Welte T, Marre R, Suttorp N. Das Kompetenznetzwerk Ambulant erworbene Pneumonie (CAPNETZ). Ein erster Zwischenbericht.  Internist (Berl). 2004;  45 393-401 (4)
  CrossrefPubMedGoogle Scholar
• 279 Mundy L M, Auwaerter P G, Oldach D. et al . Community-acquired pneumonia. Impact of immune status.  Am J Respir Crit Care Med. 1995;  152 1309-1315 (4)
  CrossrefPubMedGoogle Scholar
• 280 Lieberman D, Schlaeffer F, Boldur I. et al . Multiple pathogens in adult patients admitted with community-acquired pneumonia: a one year prospective study of 346 consecutive patients.  Thorax. 1996;  51 179-184 (4)
  CrossrefPubMedGoogle Scholar
• 281 Fine M J, Auble T E, Yealy D M. et al . A prediction rule to identify low-risk patients with community-acquired pneumonia.  N Engl J Med. 1997;  336 243-250 (2c)
  CrossrefPubMedGoogle Scholar
• 282 Roson B, Carratala J, Fernandez-Sabe N. et al . Causes and factors associated with early failure in hospitalized patients with community-acquired pneumonia.  Arch Intern Med. 2004;  164 502-508 (2c)
  CrossrefPubMedGoogle Scholar
• 283 Menendez R, Torres A, Zalacain R. et al . Risk factors of treatment failure in community acquired pneumonia: implications for disease outcome.  Thorax. 2004;  59 960-965 (2c)
  CrossrefPubMedGoogle Scholar
• 284 Syrjala H, Broas M, Suramo I. et al . High-resolution computed tomography for the diagnosis of community-acquired pneumonia.  Clin Infect Dis. 1998;  27 358-363 (4)
  CrossrefPubMedGoogle Scholar
• 285 Fine M J, Smith M A, Carson C A. et al . Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis.  JAMA. 1996;  275 134-141 (2a)
  CrossrefPubMedGoogle Scholar
• 286 Ahkee S, Srinath L, Ramirez J. Community-acquired pneumonia in the elderly: association of mortality with lack of fever and leukocytosis.  South Med J. 1997;  90 296-298 (2b)
  CrossrefPubMedGoogle Scholar
• 287 Almirall J, Bolibar I, Toran P. et al . Contribution of C-Reactive Protein to the Diagnosis and Assessment of Severity of Community-Acquired Pneumonia.  Chest. 2004;  125 1335-1342 (3c)
  CrossrefPubMedGoogle Scholar
• 288 van der Meer V, Neven A K, van den Broek P J, Assendelft W J. Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review.  BMJ. 2005;  331 26 (1a)
  PubMedGoogle Scholar
• 289 Smith R P, Lipworth B J, Cree I A. et al . C-reactive protein. A clinical marker in community-acquired pneumonia.  Chest. 1995;  107 1028-1031 (2b)
  CrossrefPubMedGoogle Scholar
• 290 Coelho L, Povoa P, Almeida E. et al . Usefulness of C-reactive protein in monitoring the severe community-acquired pneumonia clinical course.  Crit Care. 2007;  11 R92-R100 (3b)
  CrossrefPubMedGoogle Scholar
• 291 Christ-Crain M, Stolz D, Bingisser R. et al . Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial.  Am J Respir Crit Care Med. 2006;  174 84-93 (1b)
  CrossrefPubMedGoogle Scholar
• 292 Masia M, Gutierrez F, Shum C. et al . Usefulness of procalcitonin levels in community-acquired pneumonia according to the patients outcome research team pneumonia severity index.  Chest. 2005;  128 2223-2229 (2b)
  CrossrefPubMedGoogle Scholar
• 293 Hoogewerf M, Oosterheert J J, Hak E. et al . Prognostic factors for early clinical failure in patients with severe community-acquired pneumonia.  Clin Microbiol Infect. 2006;  12 1097-1104 (2c)
  CrossrefPubMedGoogle Scholar
• 294 Blot S I, Rodriguez A, Sole-Violan J. et al . Effects of delayed oxygenation assessment on time to antibiotic delivery and mortality in patients with severe community-acquired pneumonia.  Crit Care Med. 2007;  35 2509-2514 (2c)
  CrossrefPubMedGoogle Scholar
• 295 Josephson M A, Agger W A, Bennett C L. et al . Performance measurement in pneumonia care: beyond report cards.  Mayo Clin Proc. 1998;  73 5-9 (4)
  CrossrefPubMedGoogle Scholar
• 296 Sanyal S, Smith P R, Saha A C. et al . Initial microbiologic studies did not affect outcome in adults hospitalized with community-acquired pneumonia.  Am J Respir Crit Care Med. 1999;  160 346-348 (4)
  PubMedGoogle Scholar
• 297 Wunderink R G, Waterer G W. Appropriate microbiological testing in community-acquired pneumonia.  Chest. 2001;  119 5-7 (5)
  CrossrefPubMedGoogle Scholar
• 298 van der Eerden M M, Vlaspolder F, de Graaff C S. et al . Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study.  Thorax. 2005;  60 672-678 (1b)
  CrossrefPubMedGoogle Scholar
• 299 Metersky M L. Is the lateral decubitus radiograph necessary for the management of a parapneumonic pleural effusion?.  Chest. 2003;  124 1129-1132 (5)
  CrossrefPubMedGoogle Scholar
• 300 Colice G L, Curtis A, Deslauriers J. et al . Medical and surgical treatment of parapneumonic effusions: an evidence-based guideline.  Chest. 2000;  118 1158-1171 (5)
  CrossrefPubMedGoogle Scholar
• 301 Heath C H, Grove D I, Looke D F. Delay in appropriate therapy of Legionella pneumonia associated with increased mortality.  Eur J Clin Microbiol Infect Dis. 1996;  15 286-290 (2c)
  CrossrefPubMedGoogle Scholar
• 302 Guchev I A, Yu V L, Sinopalnikov A. et al . Management of Nonsevere Pneumonia in Military Trainees with the Urinary Antigen Test for Streptococcus pneumoniae: An Innovative Approach to Targeted Therapy.  Clinical Infectious Diseases. 2005;  40 1608-1616 (2b)
  CrossrefPubMedGoogle Scholar
• 303 Gacouin A, Le Tulzo Y, Lavoue S. et al . Severe pneumonia due to Legionella pneumophila: prognostic factors, impact of delayed appropriate antimicrobial therapy.  Intensive Care Med. 2002;  28 686-691 (2c)
  CrossrefPubMedGoogle Scholar
• 304 Meehan T P, Fine M J, Krumholz H M. et al . Quality of care, process, and outcomes in elderly patients with pneumonia.  JAMA. 1997;  278 2080-2084 (2c)
  CrossrefPubMedGoogle Scholar
• 305 Gleason P P, Meehan T P, Fine J M. et al . Associations between initial antimicrobial therapy and medical outcomes for hospitalized elderly patients with pneumonia.  Arch Intern Med. 1999;  159 2562-2572 (2c)
  CrossrefPubMedGoogle Scholar
• 306 Houck P M, MacLehose R F, Niederman M S, Lowery J K. Empiric antibiotic therapy and mortality among medicare pneumonia in patients in 10 western states: 1993, 1995, and 1997.  Chest. 2001;  119 1420-1426 (4)
  CrossrefPubMedGoogle Scholar
• 307 Martinez J A, Horcajada J P, Almela M. et al . Addition of a macrolide to a beta-lactam-based empirical antibiotic regimen is associated with lower in-hospital mortality for patients with bacteremic pneumococcal pneumonia.  Clin Infect Dis. 2003;  36 389-395 (2c)
  CrossrefPubMedGoogle Scholar
• 308 Mufson M A, Stanek R J. Bacteremic pneumococcal pneumonia in one American City: a 20-year longitudinal study, 1978 – 1997.  Am J Med. 1999;  107 34S-43S (4)
  PubMedGoogle Scholar
• 309 Stahl J E, Barza M, DesJardin J. et al . Effect of macrolides as part of initial empiric therapy on length of stay in patients hospitalized with community-acquired pneumonia.  Arch Intern Med. 1999;  159 2576-2580 (2c)
  CrossrefPubMedGoogle Scholar
• 310 Baddour L M, Yu V L, Klugman K P. et al . Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia.  Am J Respir Crit Care Med. 2004;  170 440-444 (2c)
  CrossrefPubMedGoogle Scholar
• 311 Aspa J, Rajas O, Rodriguez de C F. et al . Impact of initial antibiotic choice on mortality from pneumococcal pneumonia.  Eur Respir J. 2006;  27 1010-1019 (2c)
  PubMedGoogle Scholar
• 312 Dwyer R, Ortqvist A, Aufwerber E. et al . Addition of a macrolide to a ss-lactam in bacteremic pneumococcal pneumonia.  Eur J Clin Microbiol Infect Dis. 2006;  25 518-521 (2c)
  CrossrefPubMedGoogle Scholar
• 313 Finch R, Schurmann D, Collins O. et al . Randomized controlled trial of sequential intravenous (i. v.) and oral moxifloxacin compared with sequential i. v. and oral co-amoxiclav with or without clarithromycin in patients with community-acquired pneumonia requiring initial parenteral treatment.  Antimicrob Agents Chemother. 2002;  46 1746-1754 (1b)
  CrossrefPubMedGoogle Scholar
• 314 Correa J C, Badaro R, Bumroongkit C. et al . Randomized, open-label, parallel-group, multicenter study of the efficacy and tolerability of IV gatifloxacin with the option for oral stepdown gatifloxacin versus IV ceftriaxone (with or without erythromycin or clarithromycin) with the option for oral stepdown clarithromycin for treatment of patients with mild to moderate community-acquired pneumonia requiring hospitalization.  Clin Ther. 2003;  25 1453-1468 (1b)
  CrossrefPubMedGoogle Scholar
• 315 Frank E, Liu J, Kinasewitz G. et al . A multicenter, open-label, randomized comparison of levofloxacin and azithromycin plus ceftriaxone in hospitalized adults with moderate to severe community-acquired pneumonia.  Clin Ther. 2002;  24 1292-1308 (1b)
  CrossrefPubMedGoogle Scholar
• 316 Vergis E N, Indorf A, File Jr T M. et al . Azithromycin vs. cefuroxime plus erythromycin for empirical treatment of community-acquired pneumonia in hospitalized patients: a prospective, randomized, multicenter trial.  Arch Intern Med. 2000;  160 1294-1300 (1b)
  CrossrefPubMedGoogle Scholar
• 317 Feldman R B, Rhew D C, Wong J Y. et al . Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: a 3œ-year experience from a veterans affairs hospital.  Arch Intern Med. 2003;  163 1718-1726 (4)
  CrossrefPubMedGoogle Scholar
• 318 Williams D, Perri M, Zervos M J. Randomized comparative trial with ampicillin/sulbactam versus cefamandole in the therapy of community acquired pneumonia.  Eur J Clin Microbiol Infect Dis. 1994;  13 293-298 (1b)
  CrossrefPubMedGoogle Scholar
• 319 Norrby S R, Petermann W, Willcox P A. et al . A comparative study of levofloxacin and ceftriaxone in the treatment of hospitalized patients with pneumonia.  Scand J Infect Dis. 1998;  30 397-404 (1b)
  CrossrefPubMedGoogle Scholar
• 320 Dansey R D, Jacka P J, Strachan S A, Hay M. Comparison of cefotaxime with ceftriaxone given intramuscularly 12-hourly for community-acquired pneumonia.  Diagn Microbiol Infect Dis. 1992;  15 81-84 (1b)
  PubMedGoogle Scholar
• 321 Van den Brande P, Vondra V, Vogel F. et al . Sequential therapy with cefuroxime followed by cefuroxime axetil in community-acquired pneumonia.  Chest. 1997;  112 406-415 (1b)
  CrossrefPubMedGoogle Scholar
• 322 Vetter N, Cambronero-Hernandez E, Rohlf J. et al . A prospective, randomized, double-blind multicenter comparison of parenteral ertapenem and ceftriaxone for the treatment of hospitalized adults with community-acquired pneumonia.  Clin Ther. 2002;  24 1770-1785 (1b)
  CrossrefPubMedGoogle Scholar
• 323 Yakovlev S V, Stratchounski L S, Woods G L. et al . Ertapenem versus cefepime for initial empirical treatment of pneumonia acquired in skilled-care facilities or in hospitals outside the intensive care unit.  Eur J Clin Microbiol Infect Dis. 2006;  25 633-641 (1b)
  CrossrefPubMedGoogle Scholar
• 324 Plouffe J, Schwartz D B, Kolokathis A. et al . Clinical efficacy of intravenous followed by oral azithromycin monotherapy in hospitalized patients with community-acquired pneumonia. The Azithromycin Intravenous Clinical Trials Group.  Antimicrob Agents Chemother. 2000;  44 1796-1802 (1b)
  CrossrefPubMedGoogle Scholar
• 325 Sanchez F, Mensa J, Martinez J A. et al . Is azithromycin the first-choice macrolide for treatment of community-acquired pneumonia?.  Clin Infect Dis. 2003;  36 1239-1245 (2b)
  CrossrefPubMedGoogle Scholar
• 326 Chien S M, Pichotta P, Siepman N, Chan C K. Treatment of community-acquired pneumonia. A multicenter, double-blind, randomized study comparing clarithromycin with erythromycin. Canada-Sweden Clarithromycin-Pneumonia Study Group.  Chest. 1993;  103 697-701 (2b)
  CrossrefPubMedGoogle Scholar
• 327 Salvarezza C R, Mingrone H, Fachinelli H, Kijanczuk S. Comparison of roxithromycin with cefixime in the treatment of adults with community-acquired pneumonia.  J Antimicrob Chemother. 1998;  41 (Suppl. B) 75-80 (1b)
  CrossrefPubMedGoogle Scholar
• 328 Ortqvist A, Valtonen M, Cars O. et al . Oral empiric treatment of community-acquired pneumonia. A multicenter, double-blind, randomized study comparing sparfloxacin with roxithromycin. The Scandinavian Sparfloxacin Study Group.  Chest. 1996;  110 1499-1506 (1b)
  CrossrefPubMedGoogle Scholar
• 329 Welte T, Petermann W, Schurmann D. et al . Treatment with sequential intravenous or oral moxifloxacin was associated with faster clinical improvement than was standard therapy for hospitalized patients with community-acquired pneumonia who received initial parenteral therapy.  Clin Infect Dis. 2005;  41 1697-1705 (1b)
  CrossrefPubMedGoogle Scholar
• 330 Anzueto A, Niederman M S, Pearle J. et al . Community-Acquired Pneumonia Recovery in the Elderly (CAPRIE): efficacy and safety of moxifloxacin therapy versus that of levofloxacin therapy.  Clin Infect Dis. 2006;  42 73-81 (1b)
  CrossrefPubMedGoogle Scholar
• 331 Oosterheert J J, Bonten M JM, Hak E. et al . How good is the evidence for the recommended empirical antimicrobial treatment of patients hospitalized because of community-acquired pneumonia? A systematic review.  J Antimicrob Chemother. 2003;  52 555-563 (2a)
  CrossrefPubMedGoogle Scholar
• 332 Wasserfallen J B, Erard V, Cometta A. et al . Cost-effectiveness of full-course oral levofloxacin in severe community-acquired pneumonia.  European Respiratory Journal. 2004;  24 644-648 (1b)
  CrossrefPubMedGoogle Scholar
• 333 Oosterheert J J, Bonten M J, Schneider M M. et al . Effectiveness of early switch from intravenous to oral antibiotics in severe community acquired pneumonia: multicentre randomised trial.  BMJ. 2006;  333 1193-1197 (1b)
  CrossrefPubMedGoogle Scholar
• 334 Castro-Guardiola A, Viejo-Rodriguez A L, Soler-Simon S. et al . Efficacy and safety of oral and early-switch therapy for community-acquired pneumonia: a randomized controlled trial.  Am J Med. 2001;  111 367-374 (1b)
  CrossrefPubMedGoogle Scholar
• 335 Ramirez J A, Srinath L, Ahkee S. et al . Early switch from intravenous to oral cephalosporins in the treatment of hospitalized patients with community-acquired pneumonia.  Arch Intern Med. 1995;  155 1273-1276 (4)
  CrossrefPubMedGoogle Scholar
• 336 Paladino J A, Gudgel L D, Forrest A, Niederman M S. Cost-effectiveness of IV-to-oral switch therapy: azithromycin vs cefuroxime with or without erythromycin for the treatment of community-acquired pneumonia.  Chest. 2002;  122 1271-1279 (1b)
  CrossrefPubMedGoogle Scholar
• 337 Rhew D C, Hackner D, Henderson L. et al . The clinical benefit of in-hospital observation in ’low-risk’ pneumonia patients after conversion from parenteral to oral antimicrobial therapy.  Chest. 1998;  113 142-146 (4)
  CrossrefPubMedGoogle Scholar
• 338 Rhew D C, Tu G S, Ofman J. et al . Early switch and early discharge strategies in patients with community-acquired pneumonia: a meta-analysis.  Arch Intern Med. 2001;  161 722-727 (1a)
  CrossrefPubMedGoogle Scholar
• 339 Siegel R E, Halpern N A, Almenoff P L. et al . A prospective randomized study of inpatient i.v. antibiotics for community-acquired pneumonia. The optimal duration of therapy.  Chest. 1996;  110 965-971 (1b)
  CrossrefPubMedGoogle Scholar
• 340 Bohte R, van’t Wout J W, Lobatto S. et al . Efficacy and safety of azithromycin versus benzylpenicillin or erythromycin in community-acquired pneumonia.  Eur J Clin Microbiol Infect Dis. 1995;  14 182-187 (2b)
  CrossrefPubMedGoogle Scholar
• 341 Fine M J, Hanusa B H, Lave J R. et al . Comparison of a disease-specific and a generic severity of illness measure for patients with community-acquired pneumonia.  J Gen Intern Med. 1995;  10 359-368 (4)
  CrossrefPubMedGoogle Scholar
• 342 Samama M M, Cohen A T, Darmon J Y. et al . A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. Prophylaxis in Medical Patients with Enoxaparin Study Group.  N Engl J Med. 1999;  341 793-800 (1b)
  CrossrefPubMedGoogle Scholar
• 343 Mundy L M, Leet T L, Darst K. et al . Early mobilization of patients hospitalized with community-acquired pneumonia.  Chest. 2003;  124 883-889 (1b)
  CrossrefPubMedGoogle Scholar
• 344 Halm E A, Fine M J, Marrie T J. et al . Time to clinical stability in patients hospitalized with community-acquired pneumonia: implications for practice guidelines.  JAMA. 1998;  279 1452-1457 (4)
  CrossrefPubMedGoogle Scholar
• 345 Fine M J, Smith D N, Singer D E. Hospitalization decision in patients with community-acquired pneumonia: a prospective cohort study.  Am J Med. 1990;  89 713-721 (4)
  CrossrefPubMedGoogle Scholar
• 346 Fine M J, Singer D E, Hanusa B H. et al . Validation of a pneumonia prognostic index using the MedisGroups Comparative Hospital Database.  Am J Med. 1993;  94 153-159 (4)
  CrossrefPubMedGoogle Scholar
• 347 Halm E A, Fine M J, Kapoor W N. et al . Instability on hospital discharge and the risk of adverse outcomes in patients with pneumonia.  Arch Intern Med. 2002;  162 1278-1284 (4)
  CrossrefPubMedGoogle Scholar
• 348 Halm E A, Teirstein A S. Clinical practice. Management of community-acquired pneumonia.  N Engl J Med. 2002;  347 2039-2045 (5)
  CrossrefPubMedGoogle Scholar
• 349 Torres A, Serra B J, Ferrer A. et al . Severe community-acquired pneumonia. Epidemiology and prognostic factors.  Am Rev Respir Dis. 1991;  144 312-318 (4)
  CrossrefPubMedGoogle Scholar
• 350 Mittl Jr R L, Schwab R J, Duchin J S. et al . Radiographic resolution of community-acquired pneumonia.  Am J Respir Crit Care Med. 1994;  149 630-635 (2c)
  CrossrefPubMedGoogle Scholar
• 351 Bruns A H, Oosterheert J J, Prokop M. et al . Patterns of resolution of chest radiograph abnormalities in adults hospitalized with severe community-acquired pneumonia.  Clin Infect Dis. 2007;  45 983-991 (2c)
  CrossrefPubMedGoogle Scholar
• 352 Feinsilver S H, Fein A M, Niederman M S. et al . Utility of fiberoptic bronchoscopy in non-resolving pneumonia.  Chest. 1990;  98 1322-1326 (4)
  CrossrefPubMedGoogle Scholar
• 353 El Moussaoui R, Opmeer B C, de Borgie C A. et al . Long-term symptom recovery and health-related quality of life in patients with mild-to-moderate-severe community-acquired pneumonia.  Chest. 2006;  130 1165-1172 (2b)
  CrossrefPubMedGoogle Scholar
• 354 Waterer G W, Kessler L A, Wunderink R G. Medium-Term Survival after Hospitalization with Community-Acquired Pneumonia.  Am J Respir Crit Care Med. 2004;  169 910-914 (2c)
  CrossrefPubMedGoogle Scholar
• 355 Mortensen E M, Kapoor W N, Chang C CH, Fine M J. Assessment of mortality after long-term follow-up of patients with community-acquired pneumonia.  Clin Infect Dis. 2003;  37 1617-1624 (3b)
  CrossrefPubMedGoogle Scholar
• 356 Mortensen E M, Coley C M, Singer D E. et al . Causes of death for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team cohort study.  Arch Intern Med. 2002;  162 1059-1064 (2c)
  CrossrefPubMedGoogle Scholar
• 357 Baudouin S V. The pulmonary physician in critical care. 3: critical care management of community acquired pneumonia.  Thorax. 2002;  57 267-271 (5)
  CrossrefPubMedGoogle Scholar
• 358 Dahmash N S, Chowdhury M N. Re-evaluation of pneumonia requiring admission to an intensive care unit: a prospective study.  Thorax. 1994;  49 71-76 (4)
  CrossrefPubMedGoogle Scholar
• 359 Hook E W, Horton C A, Schaberg D R. Failure of intensive care unit support to influence mortality from pneumococcal bacteremia.  JAMA. 1983;  249 1055-1057 (2b)
  CrossrefPubMedGoogle Scholar
• 360 Kaplan V, Angus D C, Griffin M F. et al . Hospitalized community-acquired pneumonia in the elderly: age- and sex-related patterns of care and outcome in the United States.  Am J Respir Crit Care Med. 2002;  165 766-772 (4)
  CrossrefPubMedGoogle Scholar
• 361 Leroy O, Vandenbussche C, Coffinier C. et al . Community-acquired aspiration pneumonia in intensive care units. Epidemiological and prognosis data.  Am J Respir Crit Care Med. 1997;  156 1922-1929 (2c)
  CrossrefPubMedGoogle Scholar
• 362 Cosentini R, Blasi F, Raccanelli R. et al . Severe community-acquired pneumonia: a possible role for Chlamydia pneumoniae.  Respiration. 1996;  63 61-65 (4)
  CrossrefPubMedGoogle Scholar
• 363 Feldman C, Ross S, Goolam Mahomed A. et al . The aetiology of severe community-acquired pneumonia and its impact on intial, empiric, antimicrobial treatment.  Respir Med. 1995;  89 187-192 (4)
  CrossrefPubMedGoogle Scholar
• 364 Marik P E. The clinical features of severe community-acquired pneumonia presenting as septic shock. Norasept II Study Investigators.  J Crit Care. 2000;  15 85-90 (4)
  CrossrefPubMedGoogle Scholar
• 365 Moine P, Vercken J B, Chevret S. et al . Severe community-acquired pneumonia. Etiology, epidemiology, and prognosis factors.  Chest. 1994;  105 1487-1495 (4)
  CrossrefPubMedGoogle Scholar
• 366 Ortiz-Ruiz G, Caballero-Lopez J, Friedland I R. et al. . A study evaluating the efficacy, safety, and tolerability of ertapenem versus ceftriaxone for the treatment of community-acquired pneumonia in adults.  Clin Infect Dis. 2002;  34 1076-1083 (1b)
  CrossrefPubMedGoogle Scholar
• 367 Rodriguez A, Mendia A, Sirvent J M. et al . Combination antibiotic therapy improves survival in patients with community-acquired pneumonia and shock.  Crit Care Med. 2007;  35 1493-1498 (2c)
  CrossrefPubMedGoogle Scholar
• 368 Rello J, Bodi M, Mariscal D. et al . Microbiological Testing and Outcome of Patients With Severe Community-Acquired Pneumonia.  Chest. 2003;  123 174-180 (4)
  CrossrefPubMedGoogle Scholar
• 369 Boussekey N, Leroy O, Alfandari S. et al . Procalcitonin kinetics in the prognosis of severe community-acquired pneumonia.  Intensive Care Med. 2006;  32 469-472 (2c)
  CrossrefPubMedGoogle Scholar
• 370 Bandyopadhyay T, Gerardi D A, Metersky M L. A comparison of induced and expectorated sputum for the microbiological diagnosis of community acquired pneumonia.  Respiration. 2000;  67 173-176 (4)
  CrossrefPubMedGoogle Scholar
• 371 Ewig S, Schlochtermeier M, Göke N, Niederman M S. Applying sputum as a diagnostic tool in pneumonia: Limited yield, minimal impact on treatment decisions.  Chest. 2002;  121 1486-1492 (1b)
  CrossrefPubMedGoogle Scholar
• 372 Formica N, Yates M, Beers M. et al . The impact of diagnosis by legionella urinary antigen test on the epidemiology and outcomes of Legionnaires’ disease.  Epidemiol Infect. 2001;  127 275-280 (5)
  PubMedGoogle Scholar
• 373 Ruf B, Schurmann D, Horbach I. et al . Prevalence and diagnosis of Legionella pneumonia: a 3-year prospective study with emphasis on application of urinary antigen detection.  J Infect Dis. 1990;  162 1341-1348 (2b)
  PubMedGoogle Scholar
• 374 Jimenez P, Saldias F, Meneses M. et al . Diagnostic fiberoptic bronchoscopy in patients with community-acquired pneumonia. Comparison between bronchoalveolar lavage and telescoping plugged catheter cultures.  Chest. 1993;  103 1023-1027 (2b)
  CrossrefPubMedGoogle Scholar
• 375 Kahn F W, Jones J H. Analysis of bronchoalveolar lavage specimens from immunocompromized patients with a protocol applicable in the microbiology Iaboratory.  J CIin Microbiol. 1988;  26 1150-1155 (4)
  PubMedGoogle Scholar
• 376 Kumar A, Roberts D, Wood K E. et al . Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.  Crit Care Med. 2006;  34 1589-1596 (2c)
  CrossrefPubMedGoogle Scholar
• 377 Leroy O, Saux P, Bedos J P, Caulin E. Comparison of levofloxacin and cefotaxime combined with ofloxacin for ICU patients with community-acquired pneumonia who do not require vasopressors.  Chest. 2005;  128 172-183 (1b)
  CrossrefPubMedGoogle Scholar
• 378 Fink M P, Snydman D R, Niederman M S. et al. . Treatment of severe pneumonia in hospitalized patients: Results of a multicenter, randomized, double blind trial comparing intravenous ciprofloxacin with imipenem/cilastatin.  J Antimicrob Chemother. 1994;  38 547-557 (1b)
  CrossrefPubMedGoogle Scholar
• 379 Geddes A, Thaler M, Schonwald S. et al . Levofloxacin in the empirical treatment of patients with suspected bacteraemia/sepsis: comparison with imipenem/cilastatin in an open, randomized trial.  J Antimicrob Chemother. 1999;  44 799-810 (1b)
  CrossrefPubMedGoogle Scholar
• 380 Leophonte P, Veyssier P. Levofloxacin in the treatment of community-acquired pneumococcal pneumonia.  Presse Med. 1999;  28 1975-1979 (4)
  PubMedGoogle Scholar
• 381 Rello J, Catalan M, Diaz E. et al . Associations between empirical antimicrobial therapy at the hospital and mortality in patients with severe community-acquired pneumonia.  Intensive Care Med. 2002;  28 1030-1035 (2b)
  CrossrefPubMedGoogle Scholar
• 382 Waterer G W, Somes G W, Wunderink R G. Monotherapy may be suboptimal for severe bacteremic pneumococcal pneumonia.  Arch Intern Med. 2001;  161 1837-1842 (2c)
  CrossrefPubMedGoogle Scholar
• 383 Bartlett J G. Empirical therapy of community-acquired pneumonia: macrolides are not ideal choices.  Semin Respir Infect. 1997;  12 329-333 (5)
  PubMedGoogle Scholar
• 384 Safdar N, Handelsman J, Maki D G. Does combination antimicrobial therapy reduce mortality in Gram-negative bacteraemia? A meta-analysis.  Lancet Infect Dis. 2004;  4 519-527 (1a)
  CrossrefPubMedGoogle Scholar
• 385 Lim W S, Macfarlane J T. A prospective comparison of nursing home acquired pneumonia with community acquired pneumonia.  Eur Respir J. 2001;  18 362-368 (2c)
  CrossrefPubMedGoogle Scholar
• 386 Grimm H, Funke G. Bedeutung der antibakteriellen Eigenaktivität von Sulbactam und Tazobactam für die Empfindlichkeitsprüfung von Inhibitor-geschützten Penicillinen.  Chemother J. 2004;  13 238-241 (2b)
  PubMedGoogle Scholar
• 387 Paul M, Benuri-Silbiger I, Soares-Weiser K, Leibovici L. β-lactam monotherapy versus β-lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials.  BMJ. 2004;  328 668-670 (1a)
  CrossrefPubMedGoogle Scholar
• 388 Mortensen E, Restrepo M, Anzueto A, Pugh J. The impact of empiric antimicrobial therapy with a beta-lactam and fluoroquinolone on mortality for patients hospitalized with severe pneumonia.  Critical Care. 2006;  10 R8-R15 (2c)
  CrossrefPubMedGoogle Scholar
• 389 Chamot E, Boffi El Amari E, Rohner P, Van Delden C. Effectiveness of Combination Antimicrobial Therapy for Pseudomonas aeruginosa Bacteremia.  Antimicrob Agents Chemother. 2003;  47 2756-2764 (2c)
  CrossrefPubMedGoogle Scholar
• 390 Garnacho-Montero J, Sa-Borges M, Sole-Violan J. et al . Optimal management therapy for Pseudomonas aeruginosa ventilator-associated pneumonia: an observational, multicenter study comparing monotherapy with combination antibiotic therapy.  Crit Care Med. 2007;  35 1888-1895 (2c)
  CrossrefPubMedGoogle Scholar
• 391 Chapman T M, Perry C M. Cefepime: a review of its use in the management of hospitalized patients with pneumonia.  Am J Respir Med. 2003;  2 75-107 (5)
  PubMedGoogle Scholar
• 392 Chastre J, Wolff M, Fagon J Y. et al . Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.  JAMA. 2003;  290 2588-2598 (2a)
  CrossrefPubMedGoogle Scholar
• 393 Reinhart K, Brunkhorst F, Bone H. et al . Diagnosis and therapy of sepsis: guidelines of the German Sepsis Society Inc. and the German Interdisciplinary Society for Intensive and Emergency Medicine.  Anaesthesist. 2006;  55 Suppl 1 43-56 (5)
  CrossrefPubMedGoogle Scholar
• 394 Confalonieri M, Urbino R, Potena A. et al . Hydrocortisone infusion for severe community-acquired pneumonia: a preliminary randomized study.  Am J Respir Crit Care Med. 2005;  171 242-248 (1b)
  CrossrefPubMedGoogle Scholar
• 395 Fein A M, Feinsilver S H, Niederman M S. et al . When pneumonia doesn't get better.  Clin Chest Med. 1987;  8 529-541 (5)
  PubMedGoogle Scholar
• 396 Kirtland S H, Winterbauer R H. Slowly resolving, chronic, and recurrent pneumonia.  Clin Chest Med. 1991;  12 303-318 (5)
  PubMedGoogle Scholar
• 397 Ortqvist A, Hedlund J, Grillner L. et al . Aetiology, outcome and prognostic factors in patients with community acquired pneumonia requiring hospitalisation.  Eur Respir J. 1990;  3 1105-1113 (4)
  PubMedGoogle Scholar
• 398 Marrie T. Normal resolution of community-acquired pneumonia.  Semin Respir Infect. 1992;  7 289-293 (4)
  PubMedGoogle Scholar
• 399 El Sohl A A, Aquilina A T, Gunen H, Ramadan F. Radiographic resolution of community-acquired bacterial pneumonia in the elderly.  J Am Geriatr Soc. 2004;  52 224-229 (4)
  CrossrefPubMedGoogle Scholar
• 400 Metlay J P, Fine M J, Schulz R. et al . Measuring symptomatic and functional recovery in patients with community-acquired pneumonia.  J Gen Intern Med. 1997;  12 423-430 (4)
  CrossrefPubMedGoogle Scholar
• 401 Pedro-Botet M L, Sabria M, Sopena N. et al . Legionnaires Disease and HIV Infection.  Chest. 2003;  124 543-547 (2c)
  CrossrefPubMedGoogle Scholar
• 402 Pereira Gomes J C, Pedreira Jr J W, Araujo E M. et al . Impact of BAL in the management of pneumonia with treatment failure: positivity of BAL culture under antibiotic therapy.  Chest. 2000;  118 1739-1746 (2b)
  CrossrefPubMedGoogle Scholar
• 403 Menendez R, Perpina M, Torres A. Evaluation of nonresolving and progressive pneumonia.  Semin Respir Infect. 2003;  18 103-111 (5)
  PubMedGoogle Scholar
• 404 Muder R R. Pneumonia in residents of long-term care facilities: epidemiology, etiology, management, and prevention.  Am J Med. 1998;  105 319-330 (5)
  CrossrefPubMedGoogle Scholar
• 405 van der Eerden M M, Vlaspolder F, de Graaff C S. et al . Value of intensive diagnostic microbiological investigation in low- and high-risk patients with community-acquired pneumonia.  Eur J Clin Microbiol Infect Dis. 2005;  24 241-249 (2b)
  CrossrefPubMedGoogle Scholar
• 406 Franquet T. Imaging of pneumonia: trends and algorithms.  Eur Respir J. 2001;  18 196-208 (5)
  CrossrefPubMedGoogle Scholar
• 407 Tomiyama N, Muller N L, Johkoh T. et al . Acute parenchymal lung disease in immunocompetent patients: diagnostic accuracy of high-resolution CT.  AJR Am J Roentgenol. 2000;  174 1745-1750 (2b)
  CrossrefPubMedGoogle Scholar
• 408 Maskell N A, Davies C W, Nunn A J. et al . U.K. Controlled trial of intrapleural streptokinase for pleural infection.  N Engl J Med. 2005;  352 865-874 (1b)
  CrossrefPubMedGoogle Scholar
• 409 Marik P E. Aspiration pneumonitis and aspiration pneumonia.  N Engl J Med. 2001;  344 665-671 (5)
  CrossrefPubMedGoogle Scholar
• 410 Kikuchi R, Watabe N, Konno T. et al . High incidence of silent aspiration in elderly patients with community-acquired pneumonia.  Am J Respir Crit Care Med. 1994;  150 251-253 (4)
  CrossrefPubMedGoogle Scholar
• 411 Loeb M, McGeer A, McArthur M. et al . Risk factors for pneumonia and other lower respiratory tract infections in elderly residents of long-term care facilities.  Arch Intern Med. 1999;  159 2058-2064 (2c)
  CrossrefPubMedGoogle Scholar
• 412 Nakagawa T, Sekizawa K, Arai H. et al . High incidence of pneumonia in elderly patients with basal ganglia infarction.  Arch Intern Med. 1997;  157 321-324 (4)
  CrossrefPubMedGoogle Scholar
• 413 El Solh A A, Pietrantoni C, Bhat A. et al . Microbiology of severe aspiration pneumonia in institutionalized elderly.  Am J Respir Crit Care Med. 2003;  167 1650-1654 (2c)
  CrossrefPubMedGoogle Scholar
• 414 Matthay R A, Arroliga A C. Resection of pulmonary metastases.  Am Rev Respir Dis. 1993;  148 1691-1696 (5)
  PubMedGoogle Scholar
• 415 Mwandumba H C, Beeching N J. Pyogenic lung infections: factors for predicting clinical outcome of lung abscess and thoracic empyema.  Curr Opin Pulm Med. 2000;  6 234-239 (5)
  CrossrefPubMedGoogle Scholar
• 416 Ewig S, Schäfer H. Lungenabszesse neu betrachtet. Eine klinisch handlungsanleitende Klassifikation.  Pneumologie. 2001;  55 195-201 (5)
  Article in Thieme ConnectPubMedGoogle Scholar
• 417 Mansharamani N, Balachandran D, Delaney D. et al . Lung abscess in adults: clinical comparison of immunocompromised to non-immunocompromised patients.  Respir Med. 2002;  96 178-185 (3b)
  CrossrefPubMedGoogle Scholar
• 418 Hammond J M, Potgieter P D, Hanslo D. et al . The etiology and antimicrobial susceptibility patterns of microorganisms in acute community-acquired lung abscess.  Chest. 1995;  108 937-941 (4)
  CrossrefPubMedGoogle Scholar
• 419 Mansharamani N G, Koziel H. Chronic lung sepsis: lung abscess, bronchiectasis, and empyema.  Curr Opin Pulm Med. 2003;  9 181-185 (5)
  CrossrefPubMedGoogle Scholar
• 420 Porta G, Rodriguez-Carballeira M, Gomez L. et al . Thoracic infection caused by Streptococcus milleri.  Eur Respir J. 1998;  12 357-362 (4)
  CrossrefPubMedGoogle Scholar
• 421 Wong C A, Donald F, Macfarlane J T. Streptococcus milleri pulmonary disease: a review and clinical description of 25 patients.  Thorax. 1995;  50 1093-1096 (4)
  CrossrefPubMedGoogle Scholar
• 422 Yang P C, Luh K T, Lee Y C. et al . Lung abscesses: US examination and US-guided transthoracic aspiration.  Radiology. 1991;  180 171-175 (4)
  CrossrefPubMedGoogle Scholar
• 423 Hammer D L, Aranda C P, Galati V, Adams F V. Massive intrabronchial aspiration of contents of pulmonary abscess after fiberoptic bronchoscopy.  Chest. 1978;  74 306-307 (4)
  CrossrefPubMedGoogle Scholar
• 424 Gudiol F, Manresa F, Pallares R. et al . Clindamycin vs. penicillin for anaerobic lung infections. High rate of penicillin failures associated with penicillin-resistant Bacteroides melaninogenicus.  Arch Intern Med. 1990;  150 2525-2529 (1b)
  CrossrefPubMedGoogle Scholar
• 425 Levison M E, Mangura C T, Lorber B. et al . Clindamycin compared with penicillin for the treatment of anaerobic lung abscess.  Ann Intern Med. 1983;  98 466-471 (2b)
  CrossrefPubMedGoogle Scholar
• 426 Allewelt M, Schuler P, Bolcskei P L. et al . Ampicillin + sulbactam vs. clindamycin ± cephalosporin for the treatment of aspiration pneumonia and primary lung abscess.  Clin Microbiol Infect. 2004;  10 163-170 (1b)
  CrossrefPubMedGoogle Scholar
• 427 Fernandez-Sabe N, Carratala J, Dorca J. et al . Efficacy and safety of sequential amoxicillin-clavulanate in the treatment of anaerobic lung infections.  Eur J Clin Microbiol Infect Dis. 2003;  22 185-187 (4)
  PubMedGoogle Scholar
• 428 Klein J S, Schultz S, Heffner J E. Interventional radiology of the chest: image-guided percutaneous drainage of pleural effusions, lung abscess, and pneumothorax.  AJR Am J Roentgenol. 1995;  164 581-588 (5)
  PubMedGoogle Scholar
• 429 van Sonnenberg E, D’Agostino H B, Casola G. et al . Lung abscess: CT-guided drainage.  Radiology. 1991;  178 347-351 (4)
  PubMedGoogle Scholar
• 430 Fraser D W, Tsai T R, Orenstein W. et al . Legionnaires’ disease: description of an epidemic of pneumonia.  N Engl J Med. 1977;  297 1189-1197 (5)
  CrossrefPubMedGoogle Scholar
• 431 Ewig S, Tuschy P, Fätkenheuer G. Diagnostik und Therapie der Legionellen-Pneumonie.  Pneumologie. 2003;  56 695-703 (5)
  Article in Thieme ConnectPubMedGoogle Scholar
• 432 Sabria M, Pedro-Botet M L, Gomez J. et al . Fluoroquinolones vs. macrolides in the treatment of Legionnaires disease.  Chest. 2005;  128 1401-1405 (2b)
  CrossrefPubMedGoogle Scholar
• 433 Mykietiuk A, Carratala J, Fernandez-Sabe N. et al . Clinical outcomes for hospitalized patients with Legionella pneumonia in the antigenuria era: the influence of levofloxacin therapy.  Clin Infect Dis. 2005;  40 794-799 (3b)
  CrossrefPubMedGoogle Scholar
• 434 Blazquez Garrido R M, Espinosa Parra F J, Alemany F L. et al . Antimicrobial chemotherapy for Legionnaires' disease: levofloxacin versus macrolides.  Clin Infect Dis. 2005;  40 800-806 (3b)
  CrossrefPubMedGoogle Scholar
• 435 Grau S, Antonio J M, Ribes E. et al . Impact of rifampicin addition to clarithromycin in Legionella pneumophila pneumonia.  Int J Antimicrob Agents. 2006;  28 249-252 (4)
  CrossrefPubMedGoogle Scholar
• 436 Dunbar L M, Khashab M M, Kahn J B. et al . Efficacy of 750-mg, 5-day levofloxacin in the treatment of community-acquired pneumonia caused by atypical pathogens.  Curr Med Res Opin. 2004;  20 555-563 (4)
  CrossrefPubMedGoogle Scholar
• 437 Schonwald S, Kuzman I, Oreskovic K. et al . Azithromycin: single 1.5 g dose in the treatment of patients with atypical pneumonia syndrome – a randomized study.  Infection. 1999;  27 198-202 (2c)
  CrossrefPubMedGoogle Scholar
• 438 Gorak E J, Yamada S M, Brown J D. Community-acquired methicillin-resistant Staphylococcus aureus in hospitalized adults and children without known risk factors.  Clin Infect Dis. 1999;  29 797-800 (4)
  CrossrefPubMedGoogle Scholar
• 439 Nimmo G R, Playford E G. Community-acquired MRSA bacteraemia: four additional cases including one associated with severe pneumonia.  Med J Aust. 2003;  178 245 (4)
  PubMedGoogle Scholar
• 440 Dufour P, Gillet Y, Bes M. et al . Community-acquired methicillin-resistant Staphylococcus aureus infections in France: emergence of a single clone that produces Panton-Valentine leukocidin.  Clin Infect Dis. 2002;  35 819-824 (4)
  CrossrefPubMedGoogle Scholar
• 441 Witte W, Cuny C, Strommenger B. et al . Emergence of a new community acquired MRSA strain in Germany.  Euro Surveill. 2004;  9 1-2 (5)
  PubMedGoogle Scholar
• 442 Rubinstein E, Cammarata S, Oliphant T, Wunderink R G,. Linezolid Nosocomial Pneumonia Study Group . Linezolid (PNU-100766) versus vancomycin in the treatment of hospitalized patients with nosocomial pneumonia: a randomized, double-blind, multicenter study.  Clin Infect Dis. 2001;  32 402-412 (1b)
  CrossrefPubMedGoogle Scholar
• 443 Stevens D L, Herr D, Lampiris H. et al . Linezolid versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections.  Clin Infect Dis. 2002;  34 1481-1490 (1b)
  CrossrefPubMedGoogle Scholar
• 444 Bliziotis I A, Ntziora F, Lawrence K R, Falagas M E. Rifampin as adjuvant treatment of Gram-positive bacterial infections: a systematic review of comparative clinical trials.  Eur J Clin Microbiol Infect Dis. 2007;  26 849-856 (1a)
  CrossrefPubMedGoogle Scholar
• 445 Hidayat L K, Hsu D I, Quist R. et al . High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections: efficacy and toxicity.  Arch Intern Med. 2006;  166 2138-2144 (2c)
  CrossrefPubMedGoogle Scholar
• 446 Jeffres M N, Isakow W, Doherty J A. et al . A retrospective analysis of possible renal toxicity associated with vancomycin in patients with health care-associated methicillin-resistant Staphylococcus aureus pneumonia.  Clin Ther. 2007;  29 1107-1115 (4)
  CrossrefPubMedGoogle Scholar
• 447 Brier M E, Stalker D J, Aronoff G R. et al . Pharmacokinetics of linezolid in subjects with renal dysfunction.  Antimicrob Agents Chemother. 2003;  47 2775-2780 (3b)
  CrossrefPubMedGoogle Scholar
• 448 Hilf M, Yu V L, Sharp J T. et al . Antibiotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of 200 patients.  Am J Med. 1989;  87 540-546 (4)
  CrossrefPubMedGoogle Scholar
• 449 Torres A, Bauer T T, Leon C. et al. . Treatment of severe nosocomial pneumonia requiring mechanical ventilation: A prospective randomized comparison of intravenous ciprofloxacin with imipenem/cilastatin.  Thorax. 2000;  55 1033-1039 (1b)
  CrossrefPubMedGoogle Scholar
• 450 Marrie T J. Q fever pneumonia.  Current Opinion in Infectious Diseases. 2004;  17 137-142 (5)
  CrossrefPubMedGoogle Scholar
• 451 British Thoracic Society . BTS Guidelines for the Management of Community Acquired Pneumonia in Adults.  Thorax. 2001;  56 1iv-64iv (5)
  PubMedGoogle Scholar
• 452 Raoult D, Torres H, Drancourt M. Shell-vial assay: evaluation of a new technique for determining antibiotic susceptibility, tested in 13 isolates of Coxiella burnetii.  Antimicrob Agents Chemother. 1991;  35 2070-2077 (4)
  PubMedGoogle Scholar
• 453 Gikas A, Kofteridis D P, Manios A. et al . Newer Macrolides as Empiric Treatment for Acute Q Fever Infection.  Antimicrob Agents Chemother. 2001;  45 3644-3646 (4)
  CrossrefPubMedGoogle Scholar
• 454 Musso D, Drancourt M, Osscini S, Raoult D. Sequence of quinolone resistance-determining region of gyrA gene for clinical isolates and for an in vitro-selected quinolone-resistant strain of Coxiella burnetii.  Antimicrob Agents Chemother. 1996;  40 870-873 (4)
  PubMedGoogle Scholar
• 455 Beyer W E, Palache A M, de Jong J C, Osterhaus A D. Cold-adapted live influenza vaccine versus inactivated vaccine: systemic vaccine reactions, local and systemic antibody response, and vaccine efficacy. A meta-analysis.  Vaccine. 2002;  20 1340-1353 (1a)
  CrossrefPubMedGoogle Scholar
• 456 Govaert T M, Sprenger M J, Dinant G J. et al . Immune response to influenza vaccination of elderly people. A randomized double-blind placebo-controlled trial.  Vaccine. 1994;  12 1185-1189 (1b)
  CrossrefPubMedGoogle Scholar
• 457 Roos-Van Eijndhoven D G, Cools H J, Westendorp R G. et al . Randomized controlled trial of seroresponses to double dose and booster influenza vaccination in frail elderly subjects.  J Med Virol. 2001;  63 293-298 (1b)
  CrossrefPubMedGoogle Scholar
• 458 Allsup S J, Gosney M, Regan M. et al . Side effects of influenza vaccination in healthy older people: a randomised single-blind placebo-controlled trial.  Gerontology. 2001;  47 311-314 (1b)
  CrossrefPubMedGoogle Scholar
• 459 Gross P A, Hermogenes A W, Sacks H S. et al . The efficacy of influenza vaccine in elderly persons. A meta-analysis and review of the literature.  Ann Intern Med. 1995;  123 518-527 (1a)
  PubMedGoogle Scholar
• 460 Nichol K L, Margolis K L, Wuorenma J, Von Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community.  N Engl J Med. 1994;  331 778-784 (2b)
  CrossrefPubMedGoogle Scholar
• 461 Nichol K L, Wuorenma J, Von Sternberg T. Benefits of influenza vaccination for low-, intermediate-, and high-risk senior citizens.  Arch Intern Med. 1998;  158 1769-1776 (2b)
  CrossrefPubMedGoogle Scholar
• 462 Spaude K A, Abrutyn E, Kirchner C. et al . Influenza vaccination and risk of mortality among adults hospitalized with community-acquired pneumonia.  Arch Intern Med. 2007;  167 53-59 (2c)
  CrossrefPubMedGoogle Scholar
• 463 Beyer W E, de Bruijn I A, Palache A M. et al . Protection against influenza after annually repeated vaccination: a meta-analysis of serologic and field studies.  Arch Intern Med. 1999;  159 182-188 (2a)
  CrossrefPubMedGoogle Scholar
• 464 STIKO . Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut; Stand: Juli 2008.  Epidemiol Bull. 2008;  30 235-254 (5)
  PubMedGoogle Scholar
• 465 Hedlund J U, Kalin M E, Ortqvist A B, Henrichsen J. Antibody response to pneumococcal vaccine in middle-aged and elderly patients recently treated for pneumonia.  Arch Intern Med. 1994;  154 1961-1965 (4)
  CrossrefPubMedGoogle Scholar
• 466 Carson P J, Nichol K L, O’Brien J. et al . Immune function and vaccine responses in healthy advanced elderly patients.  Arch Intern Med. 2000;  160 2017-2024 (4)
  CrossrefPubMedGoogle Scholar
• 467 Konradsen H B. Quantity and avidity of pneumococcal antibodies before and up to five years after pneumococcal vaccination of elderly persons.  Clin Infect Dis. 1995;  21 616-620 (4)
  PubMedGoogle Scholar
• 468 Jackson L A, Benson P, Sneller V P. et al . Safety of revaccination with pneumococcal polysaccharide vaccine.  JAMA. 1999;  281 243-248 (4)
  CrossrefPubMedGoogle Scholar
• 469 Fine M J, Smith M A, Carson C A. et al . Efficacy of pneumococcal vaccination in adults. A meta-analysis of randomized controlled trials.  Arch Intern Med. 1994;  154 2666-2677 (1a)
  PubMedGoogle Scholar
• 470 Watson L, Wilson B J, Waugh N. Pneumococcal polysaccharide vaccine: a systematic review of clinical effectiveness in adults.  Vaccine. 2002;  20 2166-2173 (1a)
  CrossrefPubMedGoogle Scholar
• 471 Moore R A, Wiffen P J, Lipsky B A. Are the pneumococcal polysaccharide vaccines effective? Meta-analysis of the prospective trials.  BMC Fam Pract. 2000;  1 1-10 (1a)
  CrossrefPubMedGoogle Scholar
• 472 Cornu C, Yzebe D, Leophonte P. et al . Efficacy of pneumococcal polysaccharide vaccine in immunocompetent adults: a meta-analysis of randomized trials.  Vaccine. 2001;  19 4780-4790 (1a)
  CrossrefPubMedGoogle Scholar
• 473 Talbot T R, Poehling K A, Hartert T V. et al . Reduction in high rates of antibiotic-nonsusceptible invasive pneumococcal disease in Tennessee after introduction of the pneumococcal conjugate vaccine.  Clin Infect Dis. 2004;  39 641-648 (4)
  CrossrefPubMedGoogle Scholar
• 474 Fisman D N, Abrutyn E, Spaude K A. et al . Prior pneumococcal vaccination is associated with reduced death, complications, and length of stay among hospitalized adults with community-acquired pneumonia.  Clin Infect Dis. 2006;  42 1093-1101 (2c)
  CrossrefPubMedGoogle Scholar
• 475 Vila-Corcoles A, Ochoa-Gondar O, Hospital I. et al . Protective effects of the 23-valent pneumococcal polysaccharide vaccine in the elderly population: the EVAN-65 study.  Clin Infect Dis. 2006;  43 860-868 (2c)
  CrossrefPubMedGoogle Scholar
• 476 Mykietiuk A, Carratala J, Dominguez A. et al . Effect of prior pneumococcal vaccination on clinical outcome of hospitalized adults with community-acquired pneumococcal pneumonia.  Eur J Clin Microbiol Infect Dis. 2006;  25 457-462 (4)
  CrossrefPubMedGoogle Scholar
• 477 Johnstone J, Marrie T J, Eurich D T, Majumdar S R. Effect of pneumococcal vaccination in hospitalized adults with community-acquired pneumonia.  Arch Intern Med. 2007;  167 1938-1943 (2c)
  CrossrefPubMedGoogle Scholar
• 478 Christenson B, Lundbergh P, Hedlund J, Ortqvist A. Effects of a large-scale intervention with influenza and 23-valent pneumococcal vaccines in adults aged 65 years or older: a prospective study.  Lancet. 2001;  357 1008-1011 (2b)
  CrossrefPubMedGoogle Scholar
• 479 Trosini-Desert V, Germaud P, Dautzenberg B. Tobacco smoke and risk of bacterial infection.  Rev Mal Respir. 2004;  21 539-547 (2c)
  CrossrefPubMedGoogle Scholar
• 480 Dietrich E S, Brockmann S, Frank U WE, Daschner F D. The economic impact of unnecessary hospital admissions of patients with community acquired pneumonia. 15th Annual Meeting of the ISTAHC 1999; (2c). 
  PubMedGoogle Scholar
• 481 Oostenbrink J, Buijs-Van der Woude T, van Agthoven M. et al . Unit costs of inpatient hospital days.  Pharmacoeconomics. 2003;  21 263-271 (4)
  CrossrefPubMedGoogle Scholar
• 482 Ramirez J A, Vargas S, Ritter G W. et al . Early switch from intravenous to oral antibiotics and early hospital discharge: a prospective observational study of 200 consecutive patients with community-acquired pneumonia.  Arch Intern Med. 1999;  159 2449-2454 (4)
  CrossrefPubMedGoogle Scholar
• 483 Simpson S H, Marrie T J, Majumdar S R. Do guidelines guide pneumonia practice? A systematic review of interventions and barriers to best practice in the management of community-acquired pneumonia.  Respir Care Clin N Am. 2005;  11 1-13 (2a)
  CrossrefPubMedGoogle Scholar
• 484 Suwangool P, Moola-Or P, Waiwatana A. et al . Effect of a selective restriction policy on antibiotic expenditure and use: an institutional model.  J Med Assoc Thai. 1991;  74 272-275 (4)
  PubMedGoogle Scholar
• 485 Dietrich E S, Schmid M, Bucher A, Lemmen S W. Kostenreduktion in der Antibiotika-Therapie.  Krankenhauspharmazie. 1998;  19 287-292 (4)
  PubMedGoogle Scholar
• 486 O’Hanley P, Rodondi L, Coleman R. Efficacy and cost-effectiveness of antibiotic monitoring at a Veterans Administration hospital.  Chemotherapy. 1991;  37 22-25 (2b)
  CrossrefPubMedGoogle Scholar
• 487 Coley K C, Skledar S J, Fine M J. et al . Changing physician prescribing behavior: the community-acquired pneumonia intervention trial.  Am J Health Syst Pharm. 2000;  57 1506-1510 (2b)
  PubMedGoogle Scholar
• 488 Böhmer W, Loos U, Heissenberg A, Kullmann K H. Leitliniengesteuertes infektiologisches Qualitätsmanagement auf einer internistischen Allgemeinstation bei Patienten mit ambulant erworbener Pneumonie.  Chemother J. 2002;  11 83-86 (2b)
  PubMedGoogle Scholar
• 489 Lemmen S W, Hafner H, Kotterik S. et al . Influence of an infectious disease service on antibiotic prescription behavior and selection of multiresistant pathogens.  Infection. 2000;  28 384-387 (4)
  CrossrefPubMedGoogle Scholar
• 490 Dietrich E S, Jopp R, Schreier U. et al . Kosten einer leitliniengerechten Arzneimitteltherapie in Deutschland.  Gesundh ökon Qual manag. 2005;  10 35-43 (4)
  Article in Thieme ConnectPubMedGoogle Scholar
• 491 Menendez R, Reyes S, Martinez R. et al . Economic evaluation of adherence to treatment guidelines in nonintensive care pneumonia.  Eur Respir J. 2007;  29 751-756 (2b)
  CrossrefPubMedGoogle Scholar
• 492 Oosterheert J J, Bonten M J, Schneider M M, Hoepelman I M. Predicted effects on antibiotic use following the introduction of British or North American guidelines for community-acquired pneumonia in The Netherlands.  Clin Microbiol Infect. 2005;  11 992-998 (4)
  CrossrefPubMedGoogle Scholar
• 493 Omidvari K, de Boisblanc B P, Karam G. et al . Early transition to oral antibiotic therapy for community-acquired pneumonia: duration of therapy, clinical outcomes, and cost analysis.  Respir Med. 1998;  92 1032-1039 (1b)
  CrossrefPubMedGoogle Scholar
• 494 Ambrose P G, Quintiliani R, Nightingale C H, Nicolau D P. Continuous vs. intermittent infusion of cefuroxime for the treatment of community-acquired pneumonia.  Infect Dis Clin Pract. 1998;  7 463-470 (2b)
  CrossrefPubMedGoogle Scholar
• 495 Schädlich P K, Huppertz E, Brecht J G. Levofloxacin versus relevant alternatives in inpatient treatment of community-acquired pneumonia: results of a german economic evaluation. (Abstract T105).  Antiinfect Drugs Chemother. 1998;  16 62 (4)
  PubMedGoogle Scholar
• 496 Richerson M A, Ambrose P G, Quintiliani R. et al . Pharmacoeconomic evaluation of alternative antibiotic regimens in hospitalized patients with community-acquired pneumonia.  Infect Dis Clin Pract. 1998;  7 227-233 (2b)
  CrossrefPubMedGoogle Scholar
• 497 Hasali M A, Ibrahim M I, Sulaiman S A. et al . A clinical and economic study of community-acquired pneumonia between single versus combination therapy.  Pharm World Sci. 2005;  27 249-253 (1b)
  CrossrefPubMedGoogle Scholar
• 498 Jäcker A. Was sparen Generika wirklich? – Eine Analyse aus volkswirtschaftlicher Perspektive.  Ges Pol. 2004;  2004 1-4 (5)
  PubMedGoogle Scholar
• 499 Standing Medical Advisory Committee .The Path of Least Resistance. 1998: (5)
  PubMedGoogle Scholar
• 500 Kaptchuk T J. The placebo effect in alternative medicine: can the performance of a healing rutual have clinical significance?.  Ann Intern Med. 2002;  136 817-825 (5)
  PubMedGoogle Scholar
• 501 Wandstrat T L, Kaplan B. Pharmacoeconomic impact of factors affecting compliance of antibiotic regimens in the treatment of acute otitis media.  Pediatr Infect Dis J. 1997;  16 S27-S29 (4)
  CrossrefPubMedGoogle Scholar
• 502 Einarsson S, Kristjansson M, Kristinsson K G. et al . Pneumonia caused by penicillin-non-susceptible and penicillin-susceptible pneumococci in adults: a case-control study.  Scand J Infect Dis. 1998;  30 253-256 (3b)
  CrossrefPubMedGoogle Scholar
• 503 de Klerk G J, van Steijn J H, Lobatto S. et al . A randomised, multicentre study of ceftriaxone versus standard therapy in the treatment of lower respiratory tract infections.  Int J Antimicrob Agents. 1999;  12 121-127 (1b)
  CrossrefPubMedGoogle Scholar
• 504 Dietrich E S, Joseph U, Vogel F. et al . Cost-effectiveness of ceftriaxone 1 g vs. second-generation cephalosporins in the treatment of pneumonia in general medical wards in Germany.  Infection. 1999;  27 148-154 (2b)
  CrossrefPubMedGoogle Scholar
• 505 Siegel R E, Alicea M, Lee A, Blaiklock R. Comparison of 7 versus 10 days of antibiotic therapy for hospitalized patients with uncomplicated community-acquired pneumonia: A prospective, randomized, double-blind study.  Am J Ther. 1999;  6 217-222 (1b)
  CrossrefPubMedGoogle Scholar
• 506 Groth J J. A pahrmacoeconomic study: clarithromycin in bronchitis and pneumonia.  Klinikarzt. 1998;  4 22-24 (2b)
  PubMedGoogle Scholar
• 507 Huber S L, Wood J S, Weston J S. et al . Antibiotic therapy in community-acquired pneumonia and the role of the hospital pharmacist.  Am J Man Care. 1999;  5 S555-S569 (4)
  PubMedGoogle Scholar
• 508 Hueston W J, Mainous A G, Brauer N, Mercuri J. Evaluation and treatment of respiratory infections: does managed care make a difference?.  J Fam Pract. 1997;  44 572-577 (4)
  PubMedGoogle Scholar
• 509 Stelianides S, Golmard J L, Carbon C, Fantin B. Influence of socioeconomic status on features and outcome of community-acquired pneumonia.  Eur J Clin Microbiol Infect Dis. 1999;  18 704-708 (2c)
  CrossrefPubMedGoogle Scholar
• 510 Ewig S. für die BQS-Arbeitsgruppe Pneumonie . Therapiebegrenzung: Herausforderung für die ärztliche Urteilskraft.  Dt Ärztebl. 2008;  105 A878-A879 (5)
  PubMedGoogle Scholar
• 511 Bulow H H, Sprung C L, Reinhart K. et al . The world’s major religions’ points of view on end-of-life decisions in the intensive care unit.  Intensive Care Med. 2008;  34 423-430 (5)
  CrossrefPubMedGoogle Scholar
• 512 Bausewein C, Booth S, Gysels M, Higginson I. Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases.  Cochrane Database Syst Rev. 2008;  2 CD005623 (1a)
  PubMedGoogle Scholar
• 513 Bruera E, Sweeney C, Willey J. et al . A randomized controlled trial of supplemental oxygen versus air in cancer patients with dyspnea.  Palliat Med. 2003;  17 659-663 (2b)
  PubMedGoogle Scholar
• 514 Clemens K E, Klaschik E. Symptomatic therapy of dyspnea with strong opioids and its effect on ventilation in palliative care patients.  J Pain Symptom Manage. 2007;  33 473-481 (4)
  CrossrefPubMedGoogle Scholar
• 515 Perrin C, Jullien V, Duval Y, Defrance C. Noninvasive ventilation in palliative care and near the end of life.  Rev Mal Respir. 2008;  25 1227-1236 (5)
  PubMedGoogle Scholar
• 516 Headley J A, Ownby K K, John L D. The effect of seated exercise on fatigue and quality of life in women with advanced breast cancer.  Oncol Nurs Forum. 2004;  31 977-983 (2b)
  CrossrefPubMedGoogle Scholar
• 517 Fallon M, Hanks G, Cherny N. Principles of control of cancer pain.  BMJ. 2006;  332 1022-1024 (5)
  CrossrefPubMedGoogle Scholar
• 518 Sorgatz H, Hege-Scheuing G, Kopf A. et al . Langzeitanwendung von Opioiden bei nicht-tumorbedingten Schmerzen.  Dtsch Ärztebl. 2002;  99 1743-1746 (5)
  PubMedGoogle Scholar
• 519 Zwakhalen S M, Hamers J P, Berger M P. The psychometric quality and clinical usefulness of three pain assessment tools for elderly people with dementia.  Pain. 2006;  126 210-220 (2b)
  CrossrefPubMedGoogle Scholar
• 520 Davies L. Integrated care of the patient dying of nonmalignant respiratory disease.  Breathe. 2008;  5 155-157 (5)
  PubMedGoogle Scholar
• 521 Holen J C, Saltvedt I, Fayers P M. et al . Doloplus-2, a valid tool for behavioural pain assessment?.  BMC Geriatr. 2007;  7 29-37 (2b)
  CrossrefPubMedGoogle Scholar

1 Autorisierung der aktualisierten Leitlinie durch den Vorstand der Fachgesellschaft.

Prof. Dr. med. G. Höffken

Fachkrankenhaus Coswig
Universitätsklinikum Carl Gustav Carus Dresden, Medizinische Klinik I

Fetscherstr. 74
01307 Dresden

Email: gert.hoeffken@uniklinikum-dresden.de