EC Pulmonology and Respiratory Medicine

Opinion Volume 14 Issue 6 - 2025

The Negative Impact of Antibiotics on Professional Views

I Klepikov*

MD, Professor, Retired, Renton, WA, USA

*Corresponding Author: I Klepikov, MD, Professor, Retired, Renton, WA, USA.
Received: March 28, 2025; Published:May 22, 2025



More than 80 years have passed since the first practical use of antibiotics in medicine [1]. During this period, under the biological influence of the widespread use of this therapy, significant changes have occurred in the group of pathogens of non-specific inflammatory processes, for the treatment of which these drugs were primarily intended. Such transformations were accompanied by a dynamic change in the leading pathogens of inflammation, an increase in the proportion of other types of microflorae, representatives of which previously did not play a significant role in the etiology of such diseases, the growth and spread of resistant strains. Ultimately, such transformations led to a natural decrease in the effectiveness of antibiotic therapy and a reduction in justified indications not only for the use of even the most effective drugs, but also for the appointment of this type of therapy in general.

  1. Fleming A. "Streptococcal meningitis treated with penicillin". The Lancet6267 (1943): 434-438.
  2. Puzniak L., et al. “A multicenter analysis of the clinical microbiology and antimicrobial usage in hospitalized patients in the US with or without COVID-19”. BMC Infectious Diseases 1 (2021): 227.
  3. Kyriazopoulou E., et al. “BioFire® FilmArray® pneumonia panel for severe lower respiratory tract infections: subgroup analysis of a randomized clinical trial”. Infectious Diseases and Therapy 3 (2021): 1437-1449.
  4. Montes-Andujar L., et al. “Empiric antibiotics for community-acquired pneumonia in adult patients: a systematic review and a network meta-analysis”. Thorax10 (2021): 1020-1031.
  5. Cilloniz C., et al. “Management of pneumonia in critically ill patients”. British Medical Journal 375 (2021): e065871.
  6. Enne VI., et al. “Multicentre evaluation of two multiplex PCR platforms for the rapid microbiological investigation of nosocomial pneumonia in UK ICUs: the INHALE WP1 study”. Thorax12 (2022): 1220-1228.
  7. American Thoracic Society. “Guidelines for the initial management of adults with community-acquired pneumonia: Diagnosis, assessment of severity, and initial antimicrobial therapy”. American Review of Respiratory Disease 5 (1993): 1418-1426.
  8. European study on community-acquired pneumonia (ESOCAP) committee. “Guidelines for management of adult community-acquired lower respiratory tract infections”. European Respiratory Journal 11 (1998): 986-991.
  9. Ewig S and Torres A. “Severe community-acquired pneumonia”. Clinics in Chest Medicine 3 (1999): 575-587.
  10. Póvoa P., et al. “Severe community-acquired pneumonia: in search of the guiding star”. Intensive Care Medicine6 (2023): 656-658.
  11. Ruiz-Spinelli A., et al. “Severe community-acquired pneumonia in the post COVID-19 era”. Current Opinion in Critical Care5 (2023): 400-406.
  12. C Heneghan., et al. “Differentiating viral from bacterial pneumonia. April 8, 2020. The Centre for Evidence-Based Medicine. Evidence Service to support the COVID-19 response. University of Oxford (2020).
  13. Kamat IS., et al. “Procalcitonin to distinguish viral from bacterial pneumonia: A systematic review and meta-analysis”. Clinical Infectious Diseases 3 (2020): 538-542.
  14. 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 Medicine1 (2020): 62.
  15. 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 Association13 (2020): 1239-1242.
  16. 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.
  17. Zhou B., et al. “COVID‐19 pathogenesis, prognostic factors, and treatment strategy: Urgent recommendations”. Journal of Medical Virology 5 (2021): 2694-2704.
  18. WHO Revised global burden of disease 2002 estimates (2004).
  19. Rudan I., et al. “Epidemiology and etiology of childhood pneumonia”. Bulletin of the World Health Organization 5 (2008): 408-416.
  20. Ruuskanen O., et al. "Viral pneumonia". Lancet9773 (2011): 1264-1275.
  21. JFC Duarte., et al. “Role of flexible-bronchoscopy in community-acquired pneumonia - A retrospective analysis”. European Respiratory Journal60 (2016): PA2584.
  22. Lee J Quinton., et al. “Integrative physiology of pneumonia”. Physiological Reviews3 (2018): 1417-1464.
  23. Pierre-François Daquin., et al. “Hydrocortisone in severe community-acquired pneumonia”. New England Journal of Medicine21 (2023): 1931-1941.
  24. World Health Organization. Antimicrobial resistance (2023).
  25. Serwecińska Liliana. "Antimicrobials and antibiotic-resistant bacteria: a risk to the environment and to public health". Water12 (2020): 3313.
  26. Madhavi Thara. “Antibiotic Stewardship”. Medicon Medical Sciences3 (2024): 01-02.
  27. Jeremy Hsu. “AI discovers new class of antibiotics to kill resistant bacteria”. New Scientist3472 (2024): 12.
  28. 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.
  29. Berenguer J., et al. “Development and validation of a prediction model for 30-day mortality in hospitalised patients with COVID-19: the COVID-19 SEIMC score”. Thorax9 (2021): 920-929.
  30. Epaulard O., et al. “The onset of late severe lung impairment in COVID-19 is associated with high inflammation markers at admission and metabolic syndrome markers”. medRxiv (2022).
  31. Wee LE., et al. “Developments in pneumonia and priorities for research”. Lancet Respiratory Medicine 12 (2023): 1046-1047.
  32. JA Ramirez. Overview of community-acquired pneumonia in adults. Section Editor: T. M File. UpToDate, Wolters Kluwer (2024).
  33. Reid PT and Innes JA. “Respiratory medicine”. In: Ralston, SH, Penman ID, Strachan MWJ, Hobson RP (eds) Davidson's principles and practice of medicine. 23rd China: Churchill Livingstone Elsevier, (2018): 583-585.
  34. Gupta S., et al. “Association between early treatment with tocilizumab and mortality among critically ill patients with COVID-19”. JAMA Internal Medicine 1 (2020): 1-12.
  35. Karagiannidis C., et al. “Case characteristics, resource use, and outcomes of 10 021 patients with COVID-19 admitted to 920 German hospitals: an observational study”. Lancet Respiratory Medicine 9 (2020): 853-862.
  36. Antimicrobial resistance (2021).
  37. JA Jernigan., et al. “Multidrug-Resistant Bacterial Infections in U.S. Hospitalized Patients, 2012-2017”. New England Journal of Medicine 382 (2020): 1309-1319.
  38. 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.
  39. Ding H., et al. “Incidence of drug-resistant pathogens in community-acquired pneumonia at a safety net hospital”. Microbiology Spectrum 8 (2024): e00792-24.
  40. Aubry-Damon H., et al. “Antimicrobial resistance in commensal flora of pig farmers”. Emerging Infectious Diseases 5 (2004): 873-879.
  41. Albrich WC and Harbarth S. “Health-care workers: Source, vector, or victim of MRSA?”. Lancet Infectious Diseases 5 (2008): 289-301.
  42. 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 ONE6 (2010): e10990.
  43. I Klepikov. “Myths, legends and real facts about acute lung inflammation”. Cambridge Scholars Publishing, ISBN: 1-0364-0293-2, ISBN13: 978-1-0364-0293-8 (2024): 338.
  44. “Sepsis” (2024).
  45. Vincent JL., et al. “Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis”. Critical Care 1 (2019): 196.
  46. Rhee C., et al. “Prevalence, underlying causes, and preventability of sepsis-associated mortality in us acute care hospitals”. JAMA Network Open 2 (2019): e187571.
  47. Walden AP., et al. “Patients with community acquired pneumonia admitted to European intensive care units: an epidemiological survey of the GenOSept cohort”. Critical Care 2 (2014): R58.
  48. Gu X., et al. “Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment”. European Respiratory Review 157 (2020): 200038.
  49. Lin CK., et al. “Serum vascular endothelial growth factor affects tissue fluid accumulation and is associated with deteriorating tissue perfusion and oxygenation in severe sepsis: a prospective observational study”. European Journal of Medical Research 1 (2023): 155.

I Klepikov. "The Negative Impact of Antibiotics on Professional Views". EC Pulmonology and Respiratory Medicine  14.6 (2025): 01-07.

ECronicon Journal

Our Services

Quick Links

Information

Creative Commons LicenseOpen Access by ECronicon is licensed under a Creative Commons Attribution 4.0 International License
Based on a work at www.ecronicon.net