What is the relevance of antimicrobial resistance on the outcome of community-acquired pneumonia caused by Streptococcus pneumoniae? (should macrolide monotherapy be used for mild pneumonia?).

Multidrug-resistant pneumococci continue to increase worldwide. Although there are still questions regarding the relevance of β-lactam resistance, the recommendation for the use of the macrolides as monotherapy for mild community-acquired pneumonia should be revisited in view of high rates of resistance, the association of clinical failures with low-level and high-level resistance, and the lack of clinical data to support their need for empirical therapy for the atypicals.