It may be time for a novel approach
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Certain patients are at increased risk of
negative outcomes1-3

  • Common comorbidities, such as diabetes and COPD, are significant predictors for hospitalization1-3
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There are serious safety concerns with
common classes of antibiotics4-6

  • Fluoroquinolones have boxed warnings for adverse side
    effects including tendon rupture, mental health issues, aortic dissections, and hypoglycemia that can lead to coma4-6
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Hospitalization may also have negative
consequences7

  • Hospitalization can increase the risk of complications in patients with CABP/pneumonia, including risk of thromboembolic events and "superinfection" by resistant hospital bacteria7
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Antibiotic resistance continues to increase8

  • S. pneumoniae causes ~36% of all CABP in adults—but in the last 20 years, it's become increasingly resistant to older classes of antibiotics, such as macrolides, tetracyclines, and penicillins9,10
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References:
1. Liu K, Lee GC. Healthcare utilisation and cost expenditures for pneumonia in individuals with diabetes mellitus in the USA. Epidemiol Infect. 2019;147:1-5.
2. Harding JL, Benoit SR, Gregg EW, et al. Trends in rates of infections requiring hospitalization among adults with versus without diabetes in the U.S., 2000–2015. Diabetes Care. 2020;43:106-116.
3. Ramirez JA, Wiemken TL, Peyrani P, et al; for the University of Louisville Study Group. Adults hospitalized with pneumonia in the United States: incidence, epidemiology, and mortality. Clin Infect Dis. 2017;65:1806-1812.
4. Food and Drug Administration News Release. July 10, 2018. https://www.fda.gov/news-events/press-announcements/fda-updates-warnings-fluoroquinolone-antibiotics-risks-mental-health-and-low-blood-sugar-adverse. Accessed May 14, 2021.
5. Food and Drug Administration In Brief. December 20, 2018. https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-increased-risk-ruptures-or-tears-aorta-blood-vessel/fluoroquinolone-antibiotics. Accessed May 14, 2021.
6. FDA Drug Safety Communication. July 26, 2016. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-updates-warnings-oral-and-injectable-fluoroquinolone-antibiotics. Accessed May 26, 2021.
7. Mandell LA, Wunderink RG, Anzeuto A, et al. Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl 2):S27-S72.
8. Review on Antimicrobial Resistance. Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. Publication of a commission of the UK Government and the Wellcome Trust; O’Neill J, chairperson. https://amr-review.org/sites/default/files/
160525_Final%20paper_with%20cover.pdf. Accessed May 24, 2021.
9. Hamborsky J, Kroger A, Wolfe C, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th ed. https://www.cdc.gov/vaccines/pubs/pinkbook/index.html. Accessed May 21, 2021.
10. Hicks LA, Chien YW, Taylor TH, et al; for the Active Bacterial Core Surveillance (ABCs) team. Outpatient antibiotic prescribing and nonsusceptible Streptococcus pneumoniae in the United States, 1996–2003. Clin Infect Dis. 2011;53(7):631-639.
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PM-US-LEF-0334 JUN 2021