Antibiotics and Etiotropic Mirages of Acute Pneumonia
Main Article Content
Abstract
Abstract
Antibiotics, being one of the greatest discoveries of the last century, have rendered invaluable assistance in the treatment of many previously incurable conditions. However, for more than 80 years of practical application, the natural qualities of antibiotics have transformed the foundations of inflammatory processes in such a way that their own active capabilities are becoming increasingly unstable, and the need for their use is becoming less and less in demand. The observed transformations in these areas of medicine have long required fundamental analysis and reasonably radical solutions. The most indicative section for critical assessments of the problem under discussion is the state of medical care for patients with acute nonspecific inflammation of the lung tissue, allowing us to see the results of side effects of antimicrobial therapy and the disorientation they cause.
Downloads
Article Details
Copyright (c) 2025 Klepikov I.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.
We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.
Peertechz accomplice with- [CC BY 4.0]
Explanation
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:
License Name |
Permission to read and download |
Permission to display in a repository |
Permission to translate |
Commercial uses of manuscript |
CC BY 4.0 |
Yes |
Yes |
Yes |
Yes |
The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.
Silva PGOE, Batista Filho LAC, Flores IP, Victoria VES, Alexandre TM, Larissa SM. Community-acquired pneumonia: Epidemiology, diagnosis, prognostic severity scales, and new therapeutic options. Medwave. 2023;23(11):e2719. Available from: https://doi.org/10.5867/medwave.2023.11.2719
File TM, Ramirez JA. Community-acquired pneumonia. N Engl J Med. 2023;389:632–41. Available from: https://doi.org/10.1056/nejmcp2303286
Cavallazzi R, Ramirez JA. Definition, epidemiology, and pathogenesis of severe community-acquired pneumonia. Semin Respir Crit Care Med. 2024;45(2):143–57. Available from: https://doi.org/10.1055/s-0044-1779016
Podolsky SH. The changing fate of pneumonia as a public health concern in 20th-century America and beyond. Am J Public Health. 2005;95(12):2144–54. Available from: https://doi.org/10.2105/ajph.2004.048397
Gadsby NJ, Musher DM. The microbial etiology of community-acquired pneumonia in adults: from classical bacteriology to host transcriptional signatures. Clin Microbiol Rev. 2022;35:e00015–22. Available from: https://doi.org/10.1128/cmr.00015-22
Lynch JP 3rd, Zhanel GG. Streptococcus pneumoniae: does antimicrobial resistance matter? Semin Respir Crit Care Med. 2009;30(2):210–38. Available from: https://doi.org/10.1055/s-0029-1202939
Linares J, Ardanuy C, Pallares R, Fenoll A. Changes in antimicrobial resistance, serotypes and genotypes in Streptococcus pneumoniae over a 30-year period. Clin Microbiol Infect. 2010;16(5):402–10. Available from: https://doi.org/10.1111/j.1469-0691.2010.03182.x
World Health Organization. Antimicrobial resistance. 2023 Nov 21. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
Millar MR, Walsh TR, Linton CJ, Zhang S, Leeming JP, Bennett PM. Carriage of antibiotic-resistant bacteria by healthy children. J Antimicrob Chemother. 2001;47(5):605–10. Available from: https://doi.org/10.1093/jac/47.5.605
Centers for Disease Control and Prevention (CDC). Methicillin-resistant Staphylococcus aureus (MRSA) in healthcare settings. 2023. Available from: https://www.cdc.gov/mrsa/healthcare/index.html (Note: adjusted for correct URL format)
Albrich WC, Harbarth S. Health-care workers: Source, vector, or victim of MRSA? Lancet Infect Dis. 2008;8:289–301. Available from: https://doi.org/10.1016/s1473-3099(08)70097-5
Aubry-Damon H, Grenet K, Ndiaye-Sall P, Che D, Corderio E, Bougnoux M, et al. Antimicrobial resistance in commensal flora of pig farmers. Emerg Infect Dis. 2004;10:873–9. Available from: https://doi.org/10.3201/eid1005.030735
Graveland H, Wagenaar JA, Heesterbeek H, Mevius D, van Duijkeren E, Heederik D. Methicillin resistant Staphylococcus aureus ST398 in veal calf farming: human MRSA carriage related with animal antimicrobial usage and farm hygiene. PLoS One. 2010;5:e10990. Available from: https://doi.org/10.1371/journal.pone.0010990
Torres A, Jiménez P, Puig de la Bellacasa J, Celis R, González J, Gea J. Diagnostic value of nonfluoroscopic percutaneous lung needle aspiration in patients with pneumonia. Chest. 1990;98(4):840–4. Available from: https://doi.org/10.1378/chest.98.4.840
Dunn IJ, Marrie TJ, MacKeen AD, Bhan V, Janigan DT. The value of open lung biopsy in immunocompetent patients with community-acquired pneumonia requiring hospitalization. Chest. 1994;106(1):23. Available from: https://doi.org/10.1378/chest.106.1.23
Abourida Y, Rebahi H, Chichou H, Fenane H, Msougar Y, Fakhri A, et al. What open-lung biopsy teaches us about ARDS in COVID-19 patients: mechanisms, pathology, and therapeutic implications. Biomed Res Int. 2020;2020:2909673. Available from: https://doi.org/10.1155/2020/2909673
Abraham EP, Chain E. An enzyme from bacteria able to destroy penicillin. 1940. Rev Infect Dis. 1988;10(4):677–8. Available from: https://www.nature.com/articles/146837a0
Rammelkamp T. Resistance of Staphylococcus aureus to the action of penicillin. Exp Biol Med. 1942;51:386–9. Available from: https://doi.org/10.3181/00379727-51-13986
Aminov RI. A brief history of the antibiotic era: lessons learned and challenges for the future. Front Microbiol. 2010;1:134. Available from: https://doi.org/10.3389/fmicb.2010.00134
Knight M, Chiocchia V, Partlett C, Rivero-Arias O, Hua X, Hinshaw K, et al. Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial. Lancet. 2019;393(10189):2395–403. Available from: https://doi.org/10.1016/s0140-6736(19)30773-1
Menz BD, Charani E, Gordon DL, Leather AJM, Moonesinghe SR, Phillips CJ. Surgical antibiotic prophylaxis in an era of antibiotic resistance: common resistant bacteria and wider considerations for practice. Infect Drug Resist. 2021;14:5235–52. Available from: https://doi.org/10.2147/IDR.S319780
Rupp J, Bozzaro C, Schulenburg H. Prophylactic use of antibiotics – A strategy with unforeseen risks? Drug Resist Updat. 2024;77:101155. Available from: https://doi.org/10.1016/j.drup.2024.101155
Charles D. Despite pledges to cut back, farms are still using antibiotics. NPR. 2016 Dec 22. Archived from the original on 2020 Jul 26; retrieved 2018 Apr 5. Available from: https://www.wgbh.org/news/2016-12-22/despite-pledges-to-cut-back-farms-are-still-using-antibiotics
Couce A, Blazquez J. Side effects of antibiotics on genetic variability. FEMS Microbiol Rev. 2009;33:531–8. Available from: https://doi.org/10.1111/j.1574-6976.2009.00165.x
Joo HS, Chan JL, Cheung GY, Otto M. Subinhibitory concentrations of protein synthesis-inhibiting antibiotics promote increased expression of the agr virulence regulator and production of phenol-soluble modulin cytolysins in community-associated methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2010;54:4942–4. Available from: https://doi.org/10.1128/aac.00064-10
Blázquez J, Couce A, Rodríguez-Beltrán J, Rodríguez-Rojas A. Antimicrobials as promoters of genetic variation. Curr Opin Microbiol. 2012;15:561–9. Available from: https://doi.org/10.1016/j.mib.2012.07.007
Erb-Downward JR, Thompson DL, Han MK, Freeman CM, McCloskey L, Schmidt LA, et al. Analysis of the lung microbiome in the "healthy" smoker and in COPD. PLoS One. 2011;6(2):e16384. Available from: https://doi.org/10.1371/journal.pone.0016384
Beck JM, Young VB, Huffnagle GB. The microbiome of the lung. Transl Res. 2012 Oct;160(4):258–66. Available from: https://doi.org/10.1016/j.trsl.2012.02.005
Dela Cruz CS, Evans SE, Restrepo MI, Dean N, Torres A, Amara-Elori I, et al. Understanding the host in the management of pneumonia. An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc. 2021;18(7):1087–97. Available from: https://doi.org/10.1513/annalsats.202102-209st
Shoar S, Musher DM. Etiology of community-acquired pneumonia in adults: a systematic review. Pneumonia. 2020;12:11. Available from: https://doi.org/10.1186/s41479-020-00074-3
Carlos P, Gomes R, Coelho J, Chaves C, Tuna C, Louro M. CURB-65 and long-term mortality of community-acquired pneumonia: a retrospective study on hospitalized patients. Cureus. 2023;15(3):e36052. Available from: https://doi.org/10.7759/cureus.36052
Palomeque A, Cilloniz C, Soler-Comas A, Canseco-Ribas J, Rovira-Ribalta N, Motos A, Torres A. A review of the value of point-of-care testing for community-acquired pneumonia. Expert Rev Mol Diagn. 2024:1–14. Available from: https://doi.org/10.1080/14737159.2024.2391027
Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM, et al. CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373:415–27. Available from: https://doi.org/10.1056/nejmoa1500245
Cilloniz C, Dominedo C, Magdaleno D, Ferrer M, Gabarrús A, Torres A. Pure viral sepsis secondary to community-acquired pneumonia in adults: risk and prognostic factors. J Infect Dis. 2019;220:1166–71. Available from: https://doi.org/10.1093/infdis/jiz257
Ponnuthurai B, A AK, Padmamabhan A, Arjun R. Etiological and clinical profile of virus-associated community-acquired pneumonia in adults. Chest. 2020;157(6 Suppl):A55. Available from: https://doi.org/10.1016/j.chest.2020.05.063
Cilloniz C, Martin-Loeches I, Garcia-Vidal C, San Jose A, Torres A. Microbial etiology of pneumonia: epidemiology, diagnosis and resistance patterns. Int J Mol Sci. 2016;17(12):2120. Available from: https://doi.org/10.3390/ijms17122120
Musher DM, Abers MS, Bartlett JG. Evolving understanding of the causes of pneumonia in adults, with special attention to the role of pneumococcus. Clin Infect Dis. 2017;65(10):1736. Available from: https://doi.org/10.1093/cid/cix549
Castillo C. 2020 IDCA/ATS community-acquired pneumonia guideline: more micro, less macrolide, no HCAP. 15th Annual NW Regional Hospital Medicine Conference; 2020.
Joelsons D, Alencar CS, Pinho JRR, Ho YL, et al. Investigation of etiology of community-acquired pneumonia in hospitalized patients in a tertiary hospital of São Paulo City, Brazil. Braz J Infect Dis. 2023. Available from: https://doi.org/10.1016/j.bjid.2023.103690
Yun KW. Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment. Clin Exp Pediatr. 2024;67(2):80–9. Available from: https://doi.org/10.3345/cep.2022.01452
World Health Organization. Antimicrobial resistance. 2021 Nov 17. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
University of Chicago Medical Center. MRSA history timeline: the first half-century, 1959–2009. 2010. Archived from the original on 2020-02-18. Retrieved 2012-04-24.
Lhommet C, Garot D, Grammatico-Guillon L, Jourdannaud C, Asfar P, Faisy C, et al. Predicting the microbial cause of community-acquired pneumonia: can physicians or a data-driven method differentiate viral from bacterial pneumonia at patient presentation? BMC Pulm Med. 2020;20:62. Available from: https://doi.org/10.1186/s12890-020-1089-y
Sakamoto Y, Yamauchi Y, Jo T, Michihata N, Hasegawa W, Takeshima H, et al. In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study. BMC Pulm Med. 2021;21:345. Available from: https://doi.org/10.1186/s12890-021-01713-1
Covington EW, Rufe A. Identification of risk factors for multidrug-resistant organisms in community-acquired bacterial pneumonia at a community hospital. J Pharm Pract. 2023;36(2):303–8. Available from: https://doi.org/10.1177/08971900211039700
Ding H, Mang NS, Loomis J, Ortwine JK, Wei W, O’Connell EJ, Shah NJ, Prokesch BC. Incidence of drug-resistant pathogens in community-acquired pneumonia at a safety net hospital. Microbiol Spectr. 2024;12:e00792-24. Available from: https://doi.org/10.1128/spectrum.00792-24
Nuzzo JB, Ledesma JR. Why did the best prepared country in the world fare so poorly during COVID? J Econ Perspect. 2023;37:3–22. Available from: https://pubs.aeaweb.org/doi/pdfplus/10.1257/jep.37.4.3
Mathieu E, Ritchie H, Rodés-Guirao L, Appel C, Giattino C, Hasell J, et al. Coronavirus Pandemic (COVID-19). Our World in Data. 2020–2024. Available from: https://ourworldindata.org/coronavirus
Shapiro E, Pereira I, Deliso M. COVID-19 live updates: More Americans died of COVID this year than all of 2020. ABC News. 2021. Available from: https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_United_States
Editors. Dying in a Leadership Vacuum. N Engl J Med. 2020;383(15):1479–80. Available from: https://doi.org/10.1056/nejme2029812
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA. 2020;323(13):1239–42. Available from: https://doi.org/10.1001/jama.2020.2648
Murad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol. 2020;20:355–62. Available from: https://doi.org/10.1038/s41577-020-0331-4
Zhou B, Kojima S, Kawamoto A, Fukushima M. COVID‐19 pathogenesis, prognostic factors, and treatment strategy: Urgent recommendations. J Med Virol. 2021;1–11. Available from: https://doi.org/10.1002/jmv.26754
Lessons for a Pandemic (Audio Interview: H. Fineberg and E. Rubin). N Engl J Med. 2023;388:e67. Available from: https://doi.org/10.1056/nejmp2303615
Wang H, Paulson KR, Pease SA, Watson S, Comfort H, Zheng P, et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21. Lancet. 2022;399(10334):1513–36. Available from: https://pubmed.ncbi.nlm.nih.gov/35279232/
Norberg J. Sweden during the Pandemic: Pariah or Paragon? Policy Analysis no. 959. Washington, DC: Cato Institute; 2023. Available from: https://www.cato.org/policy-analysis/sweden-during-pandemic
Andersson G, Jonung L. The Covid-19 lesson from Sweden: Don't lock down. Econ Aff. 2024;44(1):3–16. Available from: https://doi.org/10.1111/ecaf.12611
Serwecińska L. Antimicrobials and antibiotic-resistant bacteria: a risk to the environment and to public health. Water. 2020;12(12):3313. Available from: https://doi.org/10.3390/w12123313
Thara M. Antibiotic stewardship. Medicon Med Sci. 2024;6(3):1–2. Available from: https://themedicon.com/pdf/medicalsciences/MCMS-06-196.pdf
Hsu J. AI discovers new class of antibiotics to kill resistant bacteria. New Sci. 2024;261(3472):12. Available from: https://doi.org/10.1016/S0262-4079(24)00011-3
Klepikov I. Myths, Legends and Real Facts About Acute Lung Inflammation. Cambridge: Cambridge Scholars Publishing; 2024. 338 p. Available from: https://www.cambridgescholars.com/product/978-1-0364-0293-8
Agafina A, Aguiar VC, Rossovskaya M, Fartoukh MS, Hajjar LA, Thiéry G, et al. Efficacy and safety of trimodulin in patients with severe COVID-19: results from a randomised, placebo-controlled, double-blind, multicentre, phase II trial (ESsCOVID). Eur J Med Res. 2024;29:418. Available from: https://doi.org/10.1186/s40001-024-02008-x
Li J, Luo Y, Li H, Yin Y, Zhang Y. Research progress of viral sepsis: etiology, pathophysiology, diagnosis, and treatment. Emerg Crit Care Med. 2024;4(2):74–81. Available from: https://journals.lww.com/eccm/fulltext/2024/06000/research_progress_of_viral_sepsis__etiology,.5.aspx
Lafon T, Cazalis MA, Hart KW, Hennessy C, Tazarourte K, Self WH, et al. SEPSIGN: early identification of sepsis signs in emergency department. Intern Emerg Med. 2024. Available from: https://doi.org/10.1007/s11739-024-03802-5
Guo Q, Li HY, Song WD, Li M, Chen XK, Liu H, et al. Contributions of individual qSOFA elements to assessment of severity and for prediction of mortality. Ann Med. 2024;56(1):2397090. Available from: https://doi.org/10.1080/07853890.2024.2397090
Mackenzie G. The definition and classification of pneumonia. Pneumonia (Nathan). 2016;8:14. Available from: https://doi.org/10.1186/s41479-016-0012-z
Jain V, Vashisht R, Yilmaz G, Bhardwaj A. Pneumonia pathology. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526116/
Darkwah S, Kotey FCN, Ahenkorah J, Adutwum-Ofosu KK, Donkor ES. Sepsis-related lung injury and the complication of extrapulmonary pneumococcal pneumonia. Diseases. 2024;12(4):72. Available from: https://doi.org/10.3390/diseases12040072
Flower L, Vozza EG, Bryant CE, Summers C. Role of inflammasomes in acute respiratory distress syndrome. Thorax. Published online 2025 Jan 30. Available from: https://thorax.bmj.com/content/thoraxjnl/early/2025/01/30/thorax-2024-222596.full.pdf