Macrolide combination antibiotic therapy should be prudently considered in complicated CAP cases and in regions with low macrolide susceptibility.

摘要

In response to the article by Martin-Loeches et al. [1] regarding improved survival in intubated patients with community-acquired pneumonia treated with combination antibiotic therapy with macrolides, we would like to address several points regarding mac-rolide resistance and study population. In the recent decade, susceptibility of pneumococcus to macrolides in Asia has been very low. Erythromy-cin susceptibility is < 20% in Taiwan and Korea, and about 25% in Hong Kong and China [2]. Macrolide-resistant strains (ermB and mefA) are widely circulating in Asia. Low susceptibility of pneumococci to macrolides is difficult to deny. According to a study in Taiwan, macrolide susceptibility of pneumococci remains low, even though macrolide usage has been decreasing for many years.