EC Pulmonology and Respiratory Medicine

Opinion Volume 15 Issue 1 - 2026

Stigmas of the Antibiotic Era in Acute Nonspecific Inflammation of the Lung

Igor Klepikov*

MD, Professor, Retired, Renton, WA, USA

*Corresponding Author: Igor Klepikov, MD, Professor, Retired, Renton, WA, USA.
Received: November 26, 2025; Published: December 15, 2025



Acute inflammation of the lung tissue of a non-specific origin has long been known under the terms "pneumonia" and "acute pneumonia" (AP). However, in the last three decades, this entity has been classified by the site and conditions of onset [1,2]. This classification principle was based on the assumption that pathogens in the environment, depending on their location, are capable of infecting a specific individual and contributing to the development of the inflammatory process in the lung. Classifying patients with AP according to different conditions of onset was proposed in the hopes of facilitating a more accurate selection of antibiotics and increasing their effectiveness.

  1. Ebby Orin. "Community-acquired pneumonia: from common pathogens to emerging resistance". Emergency Medicine Practice12 (2005).
  2. Sharma S., et al. "Radiological imaging in pneumonia: recent innovations". Current Opinion in Pulmonary Medicine3 (2007): 159-169.
  3. Luyt Charles-Edouarda Hékimian., et al. “Microbial cause of ICU-acquired pneumonia: hospital-acquired pneumonia versus ventilator-associated pneumonia”. Current Opinion in Critical Care5 (2018): 332-338.
  4. J Johnstone., et al. “Definitions, rates and associated mortality of ICU-acquired pneumonia: A multicenter cohort study”. Journal of Critical Care 75 (2023): 154284.
  5. Galerneau LM., et al. “Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP) in patients with acute exacerbation of COPD: From the French OUTCOMEREA cohort”. Critical Care1 (2023): 359.
  6. Reinke L., et al. “Update zur Pneumonie - klinisches Management 2025 unter Berücksichtigung der aktuellen Leitlinien”. Die Innere Medizin 66 (2025): 390-401.
  7. Plotkin S., et al. “Vaccines”. Elsevier - Saunders (2012): 542.
  8. Gram C. "Über die isolierte Färbung der Schizomyceten in Schnitt- und Trocken-präparaten". Fortschritte der Medizin 6 (1884): 185-189.
  9. Scientific American. Munn & Company (1887): 196.
  10. Podolsky SH. “The changing fate of pneumonia as a public health concern in 20th-century America and beyond”. American Journal of Public Health 12 (2005): 2144-2154.
  11. C Heneghan., et al. “Differentiating viral from bacterial pneumonia”. The Centre for Evidence-Based Medicine. Evidence Service to support the COVID-19 response. University of Oxford (2020).
  12. Kamat IS., et al. “Procalcitonin to distinguish viral from bacterial pneumonia: a systematic review and meta-analysis”. Clinical Infectious Diseases 3 (2020): 538-542.
  13. Lhommet C., et al. “Predicting the microbial cause of community-acquired pneumonia: can physicians or a data-driven method differentiate viral from bacterial pneumonia at patient presentation?” BMC Pulmonary Medicine 1 (2020): 62.
  14. I Klepikov. “Myths, legends and real facts about acute lung inflammation”. Cambridge Scholars Publishing (2024): 338.
  15. Shoar S and Musher DM. “Etiology of community-acquired pneumonia in adults: a systematic review”. Pneumonia 12 (2020): 11.
  16. Carlos P., et al. “CURB-65 and long-term mortality of community-acquired pneumonia: a retrospective study on hospitalized patients”. Cureus 3 (2023): e36052.
  17. Palomeque A., et al. “A review of the value of point-of-care testing for community-acquired pneumonia”. Expert Review of Molecular Diagnostics8 (2024): 729-742.
  18. Z Wu and JM McGoogan. “Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China. Summary of a report of 72 314 cases from the Chinese center for disease control and prevention”. Journal of the American Medical Association 13 (2020): 1239-1242.
  19. Murad M and Martin JC. “Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages”. Nature Reviews Immunology 6 (2020): 355-362.
  20. Zhou B., et al. “COVID‐19 pathogenesis, prognostic factors, and treatment strategy: Urgent recommendations”. Journal of Medical Virology 5 (2021): 2694-2704.
  21. Vaughn VM., et al. “Community-acquired pneumonia”. Journal of the American Medical Association 15 (2024): 1282-1295.
  22. Maricar Malinis., et al. “Community-acquired pneumonia: a US perspective on the guideline gap”. Journal of Antimicrobial Chemotherapy5 (2024): 959-961.
  23. Dao TH and Jackson CD. “What is community-acquired pneumonia?” Journal of the American Medical Association 5 (2025): 442.
  24. Rabin EE., et al. “Clinical significance of culture-negative, PCR-positive bronchoalveolar lavage results in severe pneumonia”. ERJ Open Research 6 (2023): 00343-2023.
  25. Pickens CI., et al. “Microbiology of severe community-acquired pneumonia and the role of rapid molecular techniques”. Seminars in Respiratory and Critical Care Medicine2 (2024): 158-168.
  26. Maricar Malinis., et al. “Community-acquired pneumonia: a US perspective on the guideline gap”. Journal of Antimicrobial Chemotherapy5 (2024): 959-961.
  27. Abhishek Deshpande., et al. “De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes”. Clinical Infectious Diseases8 (2021): 1314-1322.
  28. Rudan I., et al. “Epidemiology and etiology of childhood pneumonia”. Bulletin of the World Health Organization 5 (2008): 408-416.
  29. WHO Revised global burden of disease 2002 estimates (2004).
  30. Ruuskanen O., et al. "Viral pneumonia". Lancet9773 (2011): 1264-1275.
  31. Israeli R., et al. “Evaluating and comparing the content coverage of quality measure sets from Israel, the United States, and the United Kingdom”. Journal of General Internal Medicine 16 (2025): 4000-4005.
  32. AR Schuurman., et al. “The host response in different aetiologies of community-acquired pneumonia”. EBioMedicine 81 (2022): 104082.
  33. Kling K., et al. “The impact of next-generation sequencing added to multiplex PCR on antibiotic stewardship in critically ill patients with suspected pneumonia”. Diagnostics13 (2024): 1388.
  34. Flower L., et al. “Role of inflammasomes in acute respiratory distress syndrome”. Thorax4 (2025): 255-263.
  35. Shan H and Chen R. “Life support use and outcomes among patients admitted to intensive care units”. Journal of the American Medical Association (2025).
  36. Richards G., et al. “CURB-65, PSI, and APACHE II to assess mortality risk in patients with severe sepsis and community acquired pneumonia in PROWESS”. Journal of Intensive Care Medicine 1 (2011): 34-40.
  37. Singer M., et al. “The third international consensus definitions for sepsis and septic shock (Sepsis-3)”. Journal of the American Medical Association 8 (2016): 801-810.
  38. Weiss SL., et al. “Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children”. Intensive Care Medicine 1 (2020): 10-67.
  39. Boëlle P-Y., et al. “Trajectories of hospitalization in COVID-19 patients: An observational study in France”. Journal of Clinical Medicine10 (2020): 3148.
  40. Gattinoni L., et al. “COVID-19 pneumonia: pathophysiology and management”. European Respiratory Review 162 (2021): 210138.
  41. Rollas K., et al. “Septic shock in patients admitted to intensive care unit with COVID-19 pneumonia”. Eurasian Journal of Pulmonology 23 (2021): 95-100.
  42. Covington EW and Rufe A. “Identification of risk factors for multidrug-resistant organisms in community-acquired bacterial pneumonia at a community hospital”. Journal of Pharmacy Practice2 (2023): 303-308.
  43. Sakamoto Y., et al. “In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study”. BMC Pulmonary Medicine 1 (2021): 345.
  44. Ding H., et al. “Incidence of drug-resistant pathogens in community-acquired pneumonia at a safety net hospital”. Microbiology Spectrum 8 (2024): e00792-24.
  45. Serwecińska Liliana. "Antimicrobials and antibiotic-resistant bacteria: a risk to the environment and to public health". Water 12 (2020): 3313.
  46. World Health Organization. Antimicrobial resistance (2023).
  47. Madhavi Thara. “Antibiotic Stewardship”. Medicon Medical Sciences3 (2024): 01-02.
  48. Albrich WC and Harbarth S. “Health-care workers: Source, vector, or victim of MRSA?” Lancet Infectious Diseases 5 (2008): 289-301.
  49. Aubry-Damon H., et al. “Antimicrobial resistance in commensal flora of pig farmers”. Emerging Infectious Diseases 5 (2004): 873-879.
  50. Graveland H., et al. “Methicillin resistant Staphylococcus aureus ST398 in veal calf farming: human MRSA carriage related with animal antimicrobial usage and farm hygiene”. PLoS ONE 5 (2010): e10990.

Igor Klepikov. “Stigmas of the Antibiotic Era in Acute Nonspecific Inflammation of the Lung”. EC Pulmonology and Respiratory Medicine  15.1 (2026): 01-07.

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