VA Resident Report: What is the etiology and therapy options for Postobstructive community-acquired pneumonia?

The Bottom Line: This study encourages more limited antibiotic use in patients with PO-CAP. Our experience has been that when patients fail to respond to a first course of antibiotics, physicians repeat sputum cultures, which now are contaminated with newly acquired gram-negative colonizing organisms, and then give additional antibiotics to cover these newly recognized bacteria

Abers, M., Sandvall, B., Sampath, R., Zuno, C., Uy, N., Yu, V., . . . Musher, D. (n.d.). Postobstructive Pneumonia: An Underdescribed Syndrome. Clinical Infectious Diseases, 62(8), 957-961.

Postobstructive pneumonia, a pulmonary infiltrate distal to a bronchial obstruction that, in adults, is generally due to malignancy, has been reported in about 2% of patients hospitalized for community-acquired pneumonia (CAP). Opinion varies as to whether infection is responsible for POCAP. Some believe that infection is generally not involved, whereas others regard bacterial infection as the usual cause. Because conventional practice is to treat all POCAP with antibiotics, we performed a prospective study to characterize the clinical and laboratory findings in patients with this disease, with particular attention to the role of bacterial infection.

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