{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T01:36:33Z","timestamp":1775525793490,"version":"3.50.1"},"reference-count":83,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Advances in Respiratory Medicine"],"abstract":"<jats:p>A substantial increase in broad-spectrum antibiotics as empirical therapy in patients with community-acquired pneumonia (CAP) has occurred over the last 15 years. One of the driving factors leading to that has been some evidence showing an increased incidence of drug-resistant pathogens (DRP) in patients from a community with pneumonia, including methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Research has been published attempting to identify DRP in CAP through the implementation of probabilistic approaches in clinical practice. However, recent epidemiological data showed that the incidence of DRP in CAP varies significantly according to local ecology, healthcare systems and countries where the studies were performed. Several studies also questioned whether broad-spectrum antibiotic coverage might improve outcomes in CAP, as it is widely documented that broad-spectrum antibiotics overuse is associated with increased costs, length of hospital stay, drug adverse events and resistance. The aim of this review is to analyze the different approaches used to identify DRP in CAP patients as well as the outcomes and adverse events in patients undergoing broad-spectrum antibiotics.<\/jats:p>","DOI":"10.3390\/arm91030018","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T03:59:35Z","timestamp":1685505575000},"page":"224-238","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Identify Drug-Resistant Pathogens in Patients with Community-Acquired Pneumonia"],"prefix":"10.3390","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8248-7785","authenticated-orcid":false,"given":"Francesco","family":"Amati","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"Respiratory Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Bindo","sequence":"additional","affiliation":[{"name":"Respiratory Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8875-2252","authenticated-orcid":false,"given":"Anna","family":"Stainer","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"Respiratory Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2315-5737","authenticated-orcid":false,"given":"Andrea","family":"Gramegna","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"},{"name":"Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Mantero","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"},{"name":"Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-823X","authenticated-orcid":false,"given":"Mattia","family":"Nigro","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"Respiratory Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Bussini","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Bartoletti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2285-9970","authenticated-orcid":false,"given":"Francesco","family":"Blasi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"},{"name":"Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Aliberti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"},{"name":"Respiratory Unit, IRCCS Humanitas 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Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1093\/cid\/civ629","article-title":"Trends in Antibiotic Use and Nosocomial Pathogens in Hospitalized Veterans With Pneumonia at 128 Medical Centers, 2006\u20132010","volume":"61","author":"Jones","year":"2015","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Waagsb\u00f8, B., Tranung, M., Dam\u00e5s, J.K., and Heggelund, L. (2022). Antimicrobial therapy of community-acquired pneumonia during stewardship efforts and a coronavirus pandemic: An observational study. BMC Pulm. Med., 22.","DOI":"10.1186\/s12890-022-02178-6"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1016\/S1473-3099(16)30267-5","article-title":"Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): An international, observational cohort study","volume":"16","author":"Aliberti","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/cid\/cir274","article-title":"Epidemiology, antibiotic therapy, and clinical outcomes in health care-associated pneumonia: A UK cohort study","volume":"53","author":"Chalmers","year":"2011","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1183\/09031936.00091809","article-title":"Community-acquired pneumonia through Enterobacteriaceae and Pseudomonas aeruginosa: Diagnosis, incidence and predictors","volume":"35","author":"Welte","year":"2010","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.chest.2016.03.042","article-title":"Community-Acquired Pneumonia Due to Multidrug- and Non-Multidrug-Resistant Pseudomonas aeruginosa","volume":"150","author":"Ferrer","year":"2016","journal-title":"Chest"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1701190","DOI":"10.1183\/13993003.01190-2017","article-title":"Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia: A multinational point prevalence study of hospitalised patients","volume":"52","author":"Restrepo","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1001\/archinte.162.16.1849","article-title":"Community-acquired pneumonia due to gram-negative bacteria and pseudomonas aeruginosa: Incidence, risk, and prognosis","volume":"162","author":"Arancibia","year":"2002","journal-title":"Arch. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Jung, W.J., Kang, Y.A., Park, M.S., Park, S.C., Leem, A.Y., Kim, E.Y., Chung, K.S., Kim, Y.S., Kim, S.K., and Chang, J. (2013). Prediction of methicillin-resistant Staphylococcus aureus in patients with non-nosocomial pneumonia. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-370"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Minejima, E., Lou, M., Nieberg, P., and Wong-Beringer, A. (2014). Patients presenting to the hospital with MRSA pneumonia: Differentiating characteristics and outcomes with empiric treatment. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-252"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.rmed.2013.05.006","article-title":"Risk factors for methicillin-resistant Staphylococcus aureus in patients with community-onset and hospital-onset pneumonia","volume":"107","author":"Wooten","year":"2013","journal-title":"Respir. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1136\/thoraxjnl-2013-203384","article-title":"Multidrug-resistant pathogens in hospitalised patients coming from the community with pneumonia: A European perspective","volume":"68","author":"Aliberti","year":"2013","journal-title":"Thorax"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1001\/archinte.168.20.2205","article-title":"Prediction of infection due to antibiotic-resistant bacteria by select risk factors for health care-associated pneumonia","volume":"168","author":"Shorr","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s13756-022-01137-4","article-title":"Clinical risk factors for admission with Pseudomonas and multidrug-resistant Pseudomonas community-acquired pneumonia","volume":"11","author":"Idigo","year":"2022","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"704","DOI":"10.5588\/ijtld.12.0723","article-title":"Validation of a scoring tool to predict drug-resistant pathogens in hospitalised pneumonia patients","volume":"17","author":"Park","year":"2013","journal-title":"Int. J. Tuberc. Lung Dis. Off. J. Int. Union Against Tuberc. Lung Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2652","DOI":"10.1128\/AAC.03071-15","article-title":"Derivation and Multicenter Validation of the Drug Resistance in Pneumonia Clinical Prediction Score","volume":"60","author":"Webb","year":"2016","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"American Thoracic Society, and Infectious Diseases Society of America (2005). Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am. J. Respir. Crit. Care Med., 171, 388\u2013416.","DOI":"10.1164\/rccm.200405-644ST"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1093\/cid\/cir840","article-title":"Stratifying risk factors for multidrug-resistant pathogens in hospitalized patients coming from the community with pneumonia","volume":"54","author":"Aliberti","year":"2012","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1164\/rccm.201301-0079OC","article-title":"Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia","volume":"188","author":"Shindo","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/resp.12267","article-title":"Development and validation of a clinical risk score for predicting drug-resistant bacterial pneumonia in older Chinese patients","volume":"19","author":"Ma","year":"2014","journal-title":"Respirology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1513\/AnnalsATS.201407-305OC","article-title":"Risk factors associated with potentially antibiotic-resistant pathogens in community-acquired pneumonia","volume":"12","author":"Prina","year":"2015","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Falcone, M., Russo, A., Giannella, M., Cangemi, R., Scarpellini, M.G., Bertazzoni, G., Alarc\u00f3n, J.M., Taliani, G., Palange, P., and Farcomeni, A. (2015). Individualizing risk of multidrug-resistant pathogens in community-onset pneumonia. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0119528"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Shorr, A.F., Myers, D.E., Huang, D.B., Nathanson, B.H., Emons, M.F., and Kollef, M.H. (2013). A risk score for identifying methicillin-resistant Staphylococcus aureus in patients presenting to the hospital with pneumonia. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-268"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Rothberg, M.B., Haessler, S., Deshpande, A., Yu, P.C., Lindenauer, P.K., Zilberberg, M.D., Higgins, T.L., and Imrey, P.B. (2022). Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia. Infect. Control. Hosp. Epidemiol., 1\u20138. advance online publication.","DOI":"10.1017\/ice.2022.229"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1055\/s-0040-1709137","article-title":"Emerging Resistance of Gram Negative Pathogens in Community-Acquired Pneumonia","volume":"41","author":"Amati","year":"2020","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1900057","DOI":"10.1183\/13993003.00057-2019","article-title":"Broad-spectrum antibiotic use and poor outcomes in community-onset pneumonia: A cohort study","volume":"54","author":"Webb","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1093\/jac\/dku533","article-title":"Association of guideline-based antimicrobial therapy and outcomes in healthcare-associated pneumonia","volume":"70","author":"Rothberg","year":"2015","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1016\/j.rmed.2012.08.003","article-title":"Guideline-concordant antibiotic therapy and clinical outcomes in healthcare-associated pneumonia","volume":"106","author":"Webb","year":"2012","journal-title":"Respir. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s11739-012-0795-8","article-title":"Clinical impact of broad-spectrum empirical antibiotic therapy in patients with healthcare-associated pneumonia: A multicenter interventional study","volume":"7","author":"Falcone","year":"2012","journal-title":"Intern. Emerg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1001\/jamainternmed.2019.7495","article-title":"Empirical Anti-MRSA vs Standard Antibiotic Therapy and Risk of 30-Day Mortality in Patients Hospitalized for Pneumonia","volume":"180","author":"Jones","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1183\/09031936.00141110","article-title":"Guideline-concordant therapy and outcomes in healthcare-associated pneumonia","volume":"38","author":"Attridge","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_35","first-page":"124","article-title":"Extended-spectrum antibiotics for community-acquired pneumonia with a low risk for drug-resistant pathogens","volume":"124","author":"Kobayashi","year":"2022","journal-title":"Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"153","DOI":"10.7326\/M18-3640","article-title":"Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia: A Multihospital Cohort Study","volume":"171","author":"Vaughn","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_37","unstructured":"GBD 2019 Antimicrobial Resistance Collaborators (2022). Global mortality associated with 33 bacterial pathogens in 2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 400, 2221\u20132248."},{"key":"ref_38","first-page":"1815","article-title":"The Association Between Empirical Antibiotic Treatment and Mortality in Severe Infections Caused by Carbapenem-resistant Gram-negative Bacteria: A Prospective Study","volume":"67","author":"Pfeffer","year":"2018","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1093\/cid\/cit734","article-title":"Healthcare-associated pneumonia does not accurately identify potentially resistant pathogens: A systematic review and meta-analysis","volume":"58","author":"Chalmers","year":"2014","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1001\/jamainternmed.2019.7251","article-title":"Overuse of Broad-Spectrum Antibiotics for Pneumonia","volume":"180","author":"Klompas","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Tarrant, C., Colman, A.M., Jenkins, D.R., Chattoe-Brown, E., Perera, N., Mehtar, S., Nakkawita, W.M.I.D., Bolscher, M., and Krockow, E.M. (2021). Drivers of Broad-Spectrum Antibiotic Overuse across Diverse Hospital Contexts-A Qualitative Study of Prescribers in the UK, Sri Lanka and South Africa. Antibiotics, 10.","DOI":"10.3390\/antibiotics10010094"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"221","DOI":"10.3389\/fpubh.2019.00221","article-title":"Incidence and Related Factors for Hospital-Acquired Pneumonia Among Older Bedridden Patients in China: A Hospital-Based Multicenter Registry Data Based Study","volume":"7","author":"Jiao","year":"2019","journal-title":"Front. Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"Kalil","year":"2016","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1111\/j.1532-5415.2009.02279.x","article-title":"Effect of antibiotic guidelines on outcomes of hospitalized patients with nursing home-acquired pneumonia","volume":"57","author":"Akinnusi","year":"2009","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1111\/j.1440-1843.2012.02306.x","article-title":"Health care-associated pneumonia in haemodialysis patients: Clinical outcomes in patients treated with narrow versus broad spectrum antibiotic therapy","volume":"18","author":"Taylor","year":"2013","journal-title":"Respirology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/MAJ.0b013e318294833f","article-title":"Patterns of initial antibiotic therapy for community-acquired pneumonia in U.S. hospitals, 2000 to 2009","volume":"347","author":"Berger","year":"2014","journal-title":"Am. J. Med. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/CCM.0000000000002769","article-title":"Vancomycin Plus Piperacillin-Tazobactam and Acute Kidney Injury in Adults: A Systematic Review and Meta-Analysis","volume":"46","author":"Luther","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e1579","DOI":"10.1093\/cid\/ciaa1902","article-title":"Risk of Acute Kidney Injury and Clostridioides difficile Infection With Piperacillin\/Tazobactam, Cefepime, and Meropenem With or Without Vancomycin","volume":"73","author":"Lee","year":"2021","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1093\/cid\/cir895","article-title":"Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: A randomized, controlled study","volume":"54","author":"Wunderink","year":"2012","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Kang, S., Park, J., Yu, Y.M., Park, M.S., Han, E., and Chang, M.J. (2019). Comparison of acute kidney injury and clinical prognosis of vancomycin monotherapy and combination therapy with beta-lactams in the intensive care unit. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0217908"},{"key":"ref_51","first-page":"317","article-title":"Inhibition of vancomycin-induced nephrotoxicity by targeting superoxide dismutase to renal proximal tubule cells in the rat","volume":"7","author":"Nishino","year":"2002","journal-title":"Redox Rep. Commun. Free. Radic. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1007\/s00228-012-1259-9","article-title":"Vancomycin-induced nephrotoxicity: Mechanism, incidence, risk factors and special populations. A literature review","volume":"68","author":"Elyasi","year":"2012","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1002\/phar.1428","article-title":"Comparison of acute kidney injury during treatment with vancomycin in combination with piperacillin-tazobactam or cefepime","volume":"34","author":"Gomes","year":"2014","journal-title":"Pharmacotherapy"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1002\/phar.1442","article-title":"Comparison of the incidence of vancomycin-induced nephrotoxicity in hospitalized patients with and without concomitant piperacillin-tazobactam","volume":"34","author":"Burgess","year":"2014","journal-title":"Pharmacotherapy"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1097\/CCM.0000000000002245","article-title":"Impact of Acute Kidney Injury in Patients Hospitalized With Pneumonia","volume":"45","author":"Chawla","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1093\/jac\/dkq038","article-title":"Proposed changes to management of lower respiratory tract infections in response to the Clostridium difficile epidemic","volume":"65","author":"Chalmers","year":"2010","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1093\/cid\/cix947","article-title":"Risk of Subsequent Sepsis Within 90 Days After a Hospital Stay by Type of Antibiotic Exposure","volume":"66","author":"Baggs","year":"2018","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1007\/s11606-018-4430-x","article-title":"National Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults-United States, 2011-2015","volume":"33","author":"Geller","year":"2018","journal-title":"J. Gen. Intern. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1080\/14740338.2018.1462334","article-title":"An update on adverse drug reactions related to \u03b2-lactam antibiotics","volume":"17","author":"Vardakas","year":"2018","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_60","first-page":"2469","article-title":"Pneumonia and Clostridium difficile infection: Hospital acquired infection in a non-ICU department","volume":"40","author":"Carrabba","year":"2012","journal-title":"Eur. Respir. J."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Piccioni, A., Rosa, F., Manca, F., Pignataro, G., Zanza, C., Savioli, G., Covino, M., Ojetti, V., Gasbarrini, A., and Franceschi, F. (2022). Gut Microbiota and Clostridium difficile: What We Know and the New Frontiers. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232113323"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e1260","DOI":"10.1002\/mbo3.1260","article-title":"Impact of antibiotics on the human microbiome and consequences for host health","volume":"11","author":"Patangia","year":"2022","journal-title":"MicrobiologyOpen"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Becerra, M.B., Becerra, B.J., Banta, J.E., and Safdar, N. (2015). Impact of Clostridium difficile infection among pneumonia and urinary tract infection hospitalizations: An analysis of the Nationwide Inpatient Sample. BMC Infect. Dis., 15.","DOI":"10.1186\/s12879-015-0925-9"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"c2096","DOI":"10.1136\/bmj.c2096","article-title":"Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: Systematic review and meta-analysis","volume":"340","author":"Costelloe","year":"2010","journal-title":"BMJ"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"S26","DOI":"10.1016\/j.amjmed.2010.02.004","article-title":"Safety and tolerability of commonly prescribed oral antibiotics for the treatment of respiratory tract infections","volume":"123","author":"Lode","year":"2010","journal-title":"Am. J. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s11274-021-03070-x","article-title":"Nanoparticles as therapeutic options for treating multidrug-resistant bacteria: Research progress, challenges, and prospects","volume":"37","author":"Mba","year":"2021","journal-title":"World J. Microbiol. Biotechnol."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"(2010). Infectious Diseases Society of America The 10 \u00d7 \u203220 Initiative: Pursuing a global commitment to develop 10 new antibacterial drugs by 2020. Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am., 50, 1081\u20131083.","DOI":"10.1086\/652237"},{"key":"ref_68","unstructured":"(2022, September 27). WHO Publishes List of Bacteria for Which New Antibiotics Are Urgently Needed. Available online: https:\/\/www.who.int\/news-room\/detail\/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1093\/jac\/dkv339","article-title":"The Innovative Medicines Initiative\u2019s New Drugs for Bad Bugs programme: European public-private partnerships for the development of new strategies to tackle antibiotic resistance","volume":"71","author":"Bonten","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Terreni, M., Taccani, M., and Pregnolato, M. (2021). New Antibiotics for Multidrug-Resistant Bacterial Strains: Latest Research Developments and Future Perspectives. Molecules, 26.","DOI":"10.3390\/molecules26092671"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1017\/ice.2020.368","article-title":"Bacterial and fungal coinfections in COVID-19 patients hospitalized during the New York City pandemic surge","volume":"42","author":"Nori","year":"2021","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1164\/ajrccm.157.2.9705064","article-title":"Ventilator-associated pneumonia caused by potentially drug-resistant bacteria","volume":"157","author":"Trouillet","year":"1998","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_73","first-page":"268","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect. Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1378\/chest.09-2434","article-title":"Resistant pathogens in nonnosocomial pneumonia and respiratory failure: Is it time to refine the definition of health-care-associated pneumonia?","volume":"137","author":"Schreiber","year":"2010","journal-title":"Chest"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"3854","DOI":"10.1378\/chest.128.6.3854","article-title":"Epidemiology and outcomes of health-care-associated pneumonia: Results from a large US database of culture-positive pneumonia","volume":"128","author":"Kollef","year":"2005","journal-title":"Chest"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/resp.12651","article-title":"Predictors of Pseudomonas and methicillin-resistant Staphylococcus aureus in hospitalized patients with healthcare-associated pneumonia","volume":"21","author":"Metersky","year":"2016","journal-title":"Respirology"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1093\/cid\/ciy723","article-title":"Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients","volume":"68","author":"Sotgiu","year":"2019","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_79","unstructured":"Buchan, B.W., Windham, S., Faron, M.L., Balada-Llasat, J.M., Relich, R.F., Humphries, R., Miller, S., Harrington, A., Murphy, C., and Leber, A. (2018, January 20). Clinical Evaluation and Potential Impact of a Semi-Quantitative Multiplex Molecular Assay for the Identification of Pathogenic Bacteria and Viruses in Lower Respiratory specimens. Proceedings of the American Thoracic Society Conference, San Diego, CA, USA."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1086\/648678","article-title":"Etiology of community-acquired pneumonia: Increased microbiological yield with new diagnostic methods","volume":"50","author":"Johansson","year":"2010","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1128\/AAC.01805-13","article-title":"Predictive value of methicillin-resistant Staphylococcus aureus (MRSA) nasal swab PCR assay for MRSA pneumonia","volume":"58","author":"Dangerfield","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/cid\/ciy024","article-title":"The Clinical Utility of Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Screening to Rule Out MRSA Pneumonia: A Diagnostic Meta-analysis With Antimicrobial Stewardship Implications","volume":"67","author":"Parente","year":"2018","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.3389\/fmicb.2018.02419","article-title":"Staphylococcus aureus Nasal Colonization: An Update on Mechanisms, Epidemiology, Risk Factors, and Subsequent Infections","volume":"9","author":"Sakr","year":"2018","journal-title":"Front. Microbiol."}],"container-title":["Advances in Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2543-6031\/91\/3\/18\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:45:56Z","timestamp":1760125556000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2543-6031\/91\/3\/18"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,31]]},"references-count":83,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["arm91030018"],"URL":"https:\/\/doi.org\/10.3390\/arm91030018","relation":{},"ISSN":["2543-6031"],"issn-type":[{"value":"2543-6031","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,31]]}}}