Can we readily identify patients who need antibiotics in a severe influenza pandemic?

Charles, Patrick G P; Johnson, Paul D R; Collignon, Peter J

doi:10.5694/j.1326-5377.2009.tb02922.x

To the Editor: The current pandemic influenza A (H1N1) strain first caused infections in Mexico in April 2009 and rapidly spread to over 160 countries. Confirmed laboratory infections now number over 160 000, with millions of people probably already infected and further spread inevitable.1

1 Department of Infectious Diseases, Austin Health, Melbourne, VIC.
2 Department of Infectious Diseases and Microbiology, The Canberra Hospital, Canberra, ACT.

Correspondence: patrick.charles@austin.org.au

1. World Health Organization. Pandemic (H1N1) 2009 — update 60. http://www.who.int/csr/don/2009_08_04/en/index.html (accessed Aug 2009).
2. Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis 2008; 198: 962-970.
3. Brundage JF, Shanks GD. Deaths from bacterial pneumonia during 1918–19 influenza pandemic. Emerg Infect Dis 2008; 14: 1193-1199.
4. Australian Government Department of Health and Ageing. Resource — clinical management of pandemic (H1N1) 2009. http://www.public.health.wa. gov.au/cproot/2382/2/090709%20Clinical%20 Resource%20H1N1%2009%20-%20FINALGDL.pdf (accessed Sep 2009).
5. Charles PG, Whitby M, Fuller AJ, et al. The etiology of community-acquired pneumonia in Australia: why penicillin plus doxycycline or a macrolide is the most appropriate therapy. Clin Infect Dis 2008; 46: 1513-1521.
6. Charles PG, Wolfe R, Whitby M, et al. SMART-COP: a tool for predicting need for intensive respiratory or vasopressor support in community-acquired pneumonia. Clin Infect Dis 2008; 47: 375-384.

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