Macrolide therapy of pneumonia: Is it necessary, and how does it help?

Purpose of review: An update and literature review assessing the implications for use of macrolide therapy for patients with pneumonia is very relevant. Multiple studies have focused on assessing the efficacy, clinical effectiveness and clinical risks associated with the use of macrolides. Recent findings: The scope of this review is on recently published literature regarding the use of macrolides in patients with pneumonia. Recent evidence suggests that macrolides may benefit several populations of patients with pneumonia that includes ambulatory care, hospitalized patients with nonsevere pneumonia and severe pneumonia patients requiring ICU admission. In addition, there is benefit among patients with pneumococcal pneumonia, particularly those patients hospitalized with severe disease. The contradictory results that emerged from recent randomized controlled trials testing the efficacy of macrolide are discussed. Important remarks are made to the risks of cardiovascular events related to the use of macrolides and the clinical implications for care. Summary: A careful decision on the use of macrolides in patients with pneumonia will need to balance the possible beneficial effects and the risks linked to their use.