Unaccounted Side Effects of Antibiotics and their Role in Solving the Problem of Acute Pneumonia

Acute pneumonia (AP) is characterized by unpredictable clinical manifestations and; in severe cases; persistent progression of the inflammatory process despite intensive therapy. Treatment principles for this category of patients are based on the AP ideology; which for nearly a century has viewed nonspecific inflammatory pathogens as the primary cause of the disease; and antibiotics as the primary; and often only; treatment method. The most significant biological side effect of the long-term use of these etiotropic drugs has been the constant shift in the spectrum of AP pathogens; leading to the gradual predominance of etiologic agents outside the range of antibiotic activity. Maintaining the previous understanding of the disease and ignoring the contradictions between obvious facts and the canons of medical science; amid declining antibiotic effectiveness; has led to an exaggeration of the danger of resistant strains. However; a balanced and critical analysis of available materials on this topic convinces us that the main consequence of antibiotic use is its negative didactic effect; the elimination of which requires a fundamental revision of the AP doctrine.

Keywords:Acute pneumonia; Etiology; Antibiotics; Change in the etiology of pneumonia; Resistant microflora; Concept of acute pneumonia; Didactic effect of antibiotics

Abbreviations:AP: acute pneumonia; CAP: community-acquired pneumonia; COVID-19: coronavirus disease 2019; HAP: hospital-acquired pneumonia; ICU: intensive care unit; ICUAP: intensive care unit-associated pneumonia; MRSA: methylenepenicillin-resistant Staphylococcus aureus; SARS-CoV-2: coronavirus pandemic; VAP: ventilator-associated pneumonia; WHO: World Health Organization