Errors and Hazards in the Diagnosis and Treatment of Bacterial Pneumonias

Abstract

A review of a spectrum of bacterial pneumonia seen at a large county hospital illustrates that despite antibiotics, which are effective against almost every known pulmonary pathogen, bacterial pneumonia remains a problem. While these infections occur in a different setting compared to 30 years ago, they remain a leading cause of morbidity and mortality. Successful treatment of bacterial pneumonia involves a great deal more than the mere selection of the correct drug. The importance of making an etiologic diagnosis rapidly cannot be overemphasized. Likewise, the significance of a change in sputum flora observed following administration of antibiotics must be appreciated. Correctable mechanical factors and potential underlying systemic disease and suppressed host resistance, must be assiduously sought. In addition to appropriate antibiotics, therapy in patients with pneumonia must include adequate ventilation, drainage of secretions, and correction of other factors which predispose to infection or interfere with its resolution.