Male Speaker: Deaths from pneumonia plunge when antibiotics first came on the scene, but today some of the germs that cause the lung infection are fighting back.
John Gill Bartlett: When you look at the whole population you just see the bacteria getting more and more and more resistant.
Male speaker: Drug resistant germs tend to linger within hospitals threatening patients who are already seriously ill, but one resistant bug has been turning up in healthy people as well. It's a type of staph infection called Methicillin-resistant Staph aureus or MRSA.
Dr Marin Kollef: Methicillin-resistant staph aureus is a form of staph aureus that has acquired resistance to our major classes of antibiotics, which include the penicillin's and the penicillin like drugs will then become limited in terms of the number of available antibiotics that we have to treat this particular organism.
Dr John Gill Bartlett: It would be rare for me to see a young previously healthy person get seriously or critically ill with pneumonia, but we sure do see it with MRSA.
Male Speaker: There are several drugs that can fight this rare form of pneumonia, but timing is critical.
Dr Michael Niederman: The sooner patients get treated with the right antibiotic the less their chance of dying from their pneumonia.
Male Speaker: The problem is lab test can take up to 72 hours to identify drug resistant bacteria including MRSA. So the patient may initially be given an antibiotic that is not affected.
Dr Marin Kollef: We need to get the right drug started soon and waiting 24 to 72 hours is too late.
Male Speaker: That's why many doctors advocate the strategy known as de-escalation.
Dr Marin Kollef: If I have a patient who has the serious infection on pneumonia and it's not entirely clear what the pathogen is I'm going want to start out with an initially antibiotic regimen that's going to cover most of the likely pathogens.
Dr Michael Niederman: As we get back or diagnostic our culture data we have the opportunity two or three days later to look at that information and to narrow and focus and reduce the number of drugs the spectrum of drugs.
Male Speaker: Proponents say this approach can save lives by avoiding delays in effective therapy. Even small delays can be dangerous if the infection has entered the bloodstream and spread beyond the lungs.
Dr Marin Kollef: If, we have evidence of other organ environment even hourly delays a delay in one to two hours may be associated with worst clinical outcomes.
Male Speaker: The medical community hopes to prevent new forms of drug resistant pneumonia by using existing antibiotics carefully.
Dr Marin Kollef: We try to get by with the shortest course of antibiotics in terms of the number of the days as we can from a clinical standpoint.
Male Speaker: Another way to limit antibiotic use is to help people avoid pneumonia in the first place.
Dr Michael Niederman: Pneumococcus is the most common cause of community required pneumonia we have a very effective vaccine for that.
Male Speaker: The flu vaccine can also help because influenza makes some patients more vulnerable to bacterial pneumonia. Unfortunately there are no vaccines for the most dangerous forms of pneumonia, which is why a strong arsenal of antibiotics remains essential.
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