ASHP 2019 News Network: Current Treatment Landscape for CAP

Segment Description: Lisa Dumkow, PharmD, BCPS, BCIDP, clinical pharmacist, antimicrobial stewardship, Mercy Health Saint Mary's, provides an overview of the current treatment landscape for community-acquired pneumonia.

Interview transcript: (modified slightly for readability)

It's a really exciting time for community-acquired pneumonia. The new guidelines from the Infectious Diseases Society of America and the American Thoracic Society just came out in early October. So we have some new recommendations, some updated recommendations and some things that we're really excited about. We've also got a new drug, so lefamulin just came out also in the third quarter of this year. It's a novel antimicrobial with a novel mechanism of action, so something that could potentially change the landscape of community-acquired pneumonia treatment. So it's a really exciting time to be a steward in treating pneumonia.

I think the main challenges in treating CAP, actually, you have to take a step back, because the main challenges I think are actually in diagnosing community-acquired pneumonia. So we have some really great treatments, the problem is that viruses actually cause up to 30% of pneumonia and we just don't have great testing for that. So the majority of patients actually end up with getting antibacterial agents. So we're giving antibiotics, a lot of patients who potentially don't need them.

The issue is that the rapid diagnostic testing that we do that tests for viruses, they're expensive, they're time-intensive, potentially, and a lot of sites don't have them. And then the interpretation of those tests, again, is also up for debate in terms of how beneficial those are for patients as well. So again, we know that there's a lot of pneumonia due to viruses. It's just we just don't have the best testing.