Improving community-acquired pneumonia treatment by antimicrobial stewardship

Abstract

Antibiotic resistance is a global health threat, with overuse of antibiotics being one of its main drivers. Antimicrobial stewardship is needed to reduce inappropriate use of antibiotics. In hospitals, a substantial proportion of antibiotics is prescribed for pneumonia. Therefore, improving guideline adherence for this infection is an appealing target of antimicrobial stewardship. However, both effectiveness and safety of antimicrobial stewardship interventions in community-acquired pneumonia have not been unequivocally demonstrated. This thesis describes the methodology of studies evaluating antimicrobial stewardship interventions and discusses ways it may be improved. It investigates whether antimicrobial stewardship is effective in reducing broad-spectrum antibiotic use in patients with moderate-severe community-acquired pneumonia without compromising patient outcomes. Lastly, it explores optimal antibiotic treatment strategies in adult patients with moderate-severe community-acquired pneumonia.