Anaerobic pleuropulmonary infection.

Obligate anaerobes are the predominant constituents of normal oropharyngeal flora and produce pleuropulmonary infection in patients who are prone to aspirate. Obtaining material from these patients for culture from the site of infection that is uncontaminated by normal flora is problematic. In-vitro cultivation of obligate anaerobes requires rigorous anaerobic techniques and susceptibility testing of obligate anaerobes is not standardized in many clinical microbiology laboratories. Few clinical trials of drugs have been done in patients with laboratory documented or putative anaerobic pulmonary infection. For these reasons the diagnosis and therapy of anaerobic pulmonary infection are frequently empirical and guided by published studies of in-vitro activity against collected clinical isolates. Several new drugs that have in-vitro activity against obligate anaerobes have recently become available for empirical treatment of pneumonia.