{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:50:16Z","timestamp":1792788616105,"version":"4.5.0"},"reference-count":89,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T00:00:00Z","timestamp":1532304000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Lower respiratory tract infections are the leading cause of infectious disease deaths worldwide and are the fifth leading cause of death overall. This is despite conditions such as pneumococcal infections and influenza being largely preventable with the use of appropriate vaccines. The mainstay of treatment for the most important bacterial lower respiratory tract infections, namely acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP), is the use of antibiotics. Yet despite a number of recent publications, including clinical studies as well as several systematic literature reviews and meta-analyses, there is considerable ongoing controversy as to what the most appropriate antibiotics are for the empiric therapy of CAP in the different settings (outpatient, inpatient, and intensive care unit). Furthermore, in the case of AECOPD, there is a need for consideration of which of these exacerbations actually need antibiotic treatment. This article describes these issues and makes suggestions for appropriately managing these conditions, in the setting of the need for antimicrobial stewardship initiatives designed to slow current emerging rates of antibiotic resistance, while improving patient outcomes.<\/ns4:p>","DOI":"10.12688\/f1000research.14226.1","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T06:45:07Z","timestamp":1532328307000},"page":"1121","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":30,"title":["Appropriate antibiotic management of bacterial lower respiratory tract infections"],"prefix":"10.12688","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6881-8314","authenticated-orcid":false,"given":"Charles","family":"Feldman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Richards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2018,7,23]]},"reference":[{"key":"ref-1","first-page":"210-223","article-title":"Chapter 18. 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Sibila","year":"2016","journal-title":"Semin Respir Crit Care Med."},{"key":"ref-53","doi-asserted-by":"publisher","first-page":"E162-71","DOI":"10.21037\/jtd.2016.02.43","article-title":"Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials.","volume":"8","author":"C Feldman","year":"2016","journal-title":"J Thorac Dis."},{"key":"ref-54","doi-asserted-by":"publisher","first-page":"CD007720","DOI":"10.1002\/14651858.CD007720.pub3","article-title":"Corticosteroids for pneumonia.","volume":"12","author":"A Stern","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"ref-55","doi-asserted-by":"publisher","first-page":"30-7","DOI":"10.7196\/SAMJ.2016.v106i6.10857","article-title":"The role of appropriate diagnostic testing in acute respiratory tract infections: An antibiotic stewardship strategy to minimise diagnostic uncertainty in primary care.","volume":"106","author":"A Brink","year":"2016","journal-title":"S Afr Med J."},{"key":"ref-56","doi-asserted-by":"publisher","first-page":"196-204","DOI":"10.7326\/0003-4819-106-2-196","article-title":"Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease.","volume":"106","author":"N Anthonisen","year":"1987","journal-title":"Ann Intern Med."},{"key":"ref-57","doi-asserted-by":"publisher","first-page":"149-55","DOI":"10.1006\/pupt.2001.0289","article-title":"Antibiotic treatment and baseline severity of disease in acute exacerbations of chronic bronchitis: a re-evaluation of previously published data of a placebo-controlled randomized study.","volume":"14","author":"L Allegra","year":"2001","journal-title":"Pulm Pharmacol Ther."},{"key":"ref-58","doi-asserted-by":"publisher","first-page":"150-7","DOI":"10.1164\/rccm.200906-0837OC","article-title":"Antibiotics in addition to systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary 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