New Antibiotics for Community-Acquired Pneumonia

Marin H. Kollef; Kevin D. Betthauser


Curr Opin Infect Dis. 2019;32(2):169-175. 

In This Article

Abstract and Introduction


Purpose of review: This review provides the rationale for the development of new antibiotics to treat community-acquired pneumonia (CAP). It also provides an overview of the new antibiotics targeting CAP that have recently received approval by the regulatory agencies, and those antibiotics that are in the development pipeline.

Recent findings: CAP is one of the most common reasons for hospitalization and carries a significant morbidity and risk of mortality. Increasing antibiotic resistance amongst the common bacterial pathogens associated with CAP, especially staphylococci and Streptococcus pneumoniae, has made the empiric treatment of this infection increasingly problematic. Moreover, failure of initial empiric therapy to cover the causative agents associated with CAP can be associated with worse clinical outcomes. There have been several antibiotics newly approved or in development for the treatment of CAP. These agents include delafloxacin, omadacycline, lefamulin, solithromycin, nemonoxacin, and ceftaroline. Their major advantages include activity against methicillin-resistant Staphylococcus aureus and macrolide-resistant Strep. pneumoniae.

Summary: CAP continues to be an important infection because of its impact on patient outcomes especially in the elderly and immunocompromised hosts. The availability of new antibiotics offers an opportunity for enhanced empiric treatment of the antibiotic-resistant bacterial pathogens associated with CAP.


Community-acquired pneumonia (CAP) is one of the most common conditions requiring hospitalization with high patient morbidity, mortality and healthcare costs.[1,2,3,4] The annual incidence of CAP in the United States has recently been estimated at 248 cases per 10 000 adults and may be rising in specific demographic populations, especially the elderly and immunocompromised hosts.[5,6] During 2001–2014, the proportion of pneumonia-associated hospitalizations with an immunocompromising co-admission diagnosis increased from 18.7% in 2001 to 29.9% in 2014; and total charges for pneumonia-associated hospitalizations in 2014 were over $84 billion.[7] Pneumonia, especially CAP, is the most common infection leading to sepsis and septic shock.[8,9] Patients with CAP also frequently have comorbid conditions, such as heart failure and diabetes that not only predispose to the development of pneumonia but also influence the outcomes of patients hospitalized with CAP.[10] These factors noted above highlight the clinical importance of CAP and the need to have effective antibiotics for its treatment.