Emerging drugs for pneumococcal pneumonia.

INTRODUCTION: Nowadays, despite excellent antibiotics being available, mortality of pneumococcal pneumonia remains high. The excellent antipneumococcal activity and the large amount of clinical data available with β-lactams and fluorquinolones will probably delay the need for new antibiotics. However, concerns about the evolution of antibiotic resistance justify the review of new indications for known antibiotics and the development of new products. AREAS COVERED: In this review, the authors focus on the actual situation of pneumococcal antibiotic resistance, the different antimicrobial therapies available and future therapeutic options as well as novel therapeutic strategies. An extensive literature review of manuscripts published in the last 10 years has been performed. This is a review of all antimicrobials for the treatment of pneumococcal pneumonia. Both actual antibiotics available and new antibiotics that may have a role in the treatment of pneumococcal pneumonia are extensively reviewed. The utility of combination therapy with β-lactams and macrolides is discussed. EXPERT OPINION: β-Lactams continue to be the drugs of choice for pneumococcal pneumonia. Fluorquinolones constitute an excellent alternative therapy. Patients with shock or severe sepsis should probably receive combination therapy with β-lactams plus a macrolide due to its immunomodulatory effect.