In those situations one is likely to see ciprofloxacin-resistant pseudomonas organisms, so ciprofloxacin should probably not be used empirically in this situation; and one is also likely to see cephalosporin-resistant Gram-negatives causing pneumonia, and again this mitigates the use of these particular compounds for the treatment of pneumonia in this population.
This is an extremely difficult area to manage and these patients with pneumonias are probably best sent to a hospital situation where the appropriate cultures can be taken and the appropriate antibiotic testing done because of the presence of these multi-resistant bacteria in this patient population.
Copyright 2000