[Assessing the efficacy of antimicrobial agents based on the Japanese Respiratory Society Guidelines for a community-acquired pneumonia].
We evaluated the efficacy of antimicrobial agents used for patients with community-acquired pneumonia (CAP) based on the guidelines of Japanese Respiratory Society. A total of ninety-nine hospitalized patients who were suspected to have bacterial pneumonia at the time of admission between January, 1998 and December, 2000 were assessed. Our conclusions were as follows. 1) The rate which was considered as effective by the guidelines were 83.3% (5 of 6 cases), 98.7% (74 of 75 cases), 85.7% (12 of 14 cases), and 100% (4 of 4 cases) for penicillin, cephem, carbapenem and tetracycline, respectively. 2) These guidelines were useful and practical for identifying the etiological organisms, determining the severity of pneumonia and evaluating the efficacy of chemotherapeutic agents in CAP. 3) Gram-positive organisms were isolated more frequently among the "mild" group. The number of isolated gram-negative was increased significantly as the severity of pneumonia progressed from "mild" to "severe" group. 4) Factors such as body temperature and white cells count were not always applicable for evaluating the clinical effect in elderly cases. 5) Risk factors such as underlying diseases, or complications, age (over eighty years old) and specific etiological organisms might influence the ineffectiveness of antimicrobial agents among the cases that had no clinical response. 6) The choice of antibiotic agents for the treatment of CAP should be made with consideration to the local-specific profiles of each medical facility as described in the guidelines.