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James K. Stoller, MD, FCCP; Amit Banga, MD, FCCP; Atul C. Mehta, MD, FCCP
Author and Funding Information

From the Education Institute (Dr Stoller) and Respiratory Institute (Drs Stoller, Banga, and Mehta), Cleveland Clinic.

CORRESPONDENCE TO: Atul C. Mehta, MD, FCCP, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave, A-90, Cleveland, OH 44195; e-mail: mehtaa1@ccf.org


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(5):e190-e191. doi:10.1378/chest.15-0126
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To the Editor:

We appreciate the comments from Drs Sehgal and Agarwal affirming that American College of Chest Physicians (CHEST) guidelines are not global in coverage.1,2 Their arguments that the Infectious Diseases of America/American Thoracic Society guideline-based recommendation of quinolones for community-acquired pneumonia are ill advised in India because of the risk of incurring TB resistance and that use of urinary antigen diagnostics for Streptococcus and Legionella is unaffordable in resource-constrained settings affirm our arguments that North American-centric guidelines do not apply in the developing world.3-5 We agree with their proposed solution that CHEST guidelines must be revised by local chest societies to reflect the specific clinical and socioeconomic contexts in which the guidelines will be deployed.

References

Mehta AC, Banga A, Stoller J. COUNTERPOINT: are the CHEST guidelines global in coverage? No. Chest. 2015;147(1):13-15. [CrossRef] [PubMed]
 
Nathanson I, Ouellette DR. POINT: are the CHEST guidelines global in coverage? Yes. Chest. 2015;147(1):11-13. [CrossRef] [PubMed]
 
Mandell LA, Wunderink RG, Anzueto A, et al; Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(suppl 2):S27-S72. [CrossRef] [PubMed]
 
Adriaenssens N, Coenen S, Versporten A, et al; ESAC Project Group. European Surveillance of Antimicrobial Consumption (ESAC): outpatient quinolone use in Europe (1997-2009). J Antimicrob Chemother. 2011;66(suppl 6):vi47-vi56. [PubMed]
 
Migliori GB, Langendam MW, D’Ambrosio L, et al. Protecting the tuberculosis drug pipeline: stating the case for the rational use of fluoroquinolones. Eur Respir J. 2012;40(4):814-822. [CrossRef] [PubMed]
 

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Tables

References

Mehta AC, Banga A, Stoller J. COUNTERPOINT: are the CHEST guidelines global in coverage? No. Chest. 2015;147(1):13-15. [CrossRef] [PubMed]
 
Nathanson I, Ouellette DR. POINT: are the CHEST guidelines global in coverage? Yes. Chest. 2015;147(1):11-13. [CrossRef] [PubMed]
 
Mandell LA, Wunderink RG, Anzueto A, et al; Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(suppl 2):S27-S72. [CrossRef] [PubMed]
 
Adriaenssens N, Coenen S, Versporten A, et al; ESAC Project Group. European Surveillance of Antimicrobial Consumption (ESAC): outpatient quinolone use in Europe (1997-2009). J Antimicrob Chemother. 2011;66(suppl 6):vi47-vi56. [PubMed]
 
Migliori GB, Langendam MW, D’Ambrosio L, et al. Protecting the tuberculosis drug pipeline: stating the case for the rational use of fluoroquinolones. Eur Respir J. 2012;40(4):814-822. [CrossRef] [PubMed]
 
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