The most appropriate therapeutic strategy for acute lower respiratory tract infections: a Delphi-based approach

Francesco Blasi, Ercole Concia, Bruno del Prato, Massimo Giusti, Teresita Mazzei, Barbara Polistena, Alessandro Rossi, Stefania Stefani, Andrea Novelli, behalf of the *MASTER working group On behalf of the *MASTER working group

Research output: Contribution to journalArticle


Lower respiratory tract infections (LRTIs) cause high morbidity and mortality worldwide. Empiric therapy often base the choice of antibiotic treatment on antibacterial spectrum of the agent rather than on its pharmacological properties or the pathogen resistance profile. Inappropriate prescribing leads to therapeutic failure and antibiotic resistance, with increasing direct and indirect health costs. A consensus on appropriate prescribing in LRTI therapy was appraised by this Delphi exercise, based on a panel of 70 pulmonologists, coordinated by a Scientific Committee of nine experts in respiratory medical care. Full or very high consensus was reached on several issues, including the role of oral cephalosporins in first-line treatments of LRTIs and the appropriateness of cefditoren, with balanced spectrum and high intrinsic activity, in LRTI treatment. Evidence-based medicine approach and a comprehensive process of disease management, from diagnosis to therapy and follow-up, should guide antibiotic prescribing.

Original languageEnglish
Pages (from-to)274-286
Number of pages13
JournalJournal of Chemotherapy
Issue number5
Publication statusPublished - 2017



  • Antibiotic resistance
  • Cefditoren
  • Cephalosporins
  • Delphi-based consensus
  • LRTIs
  • Prescribing appropriateness

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Blasi, F., Concia, E., del Prato, B., Giusti, M., Mazzei, T., Polistena, B., Rossi, A., Stefani, S., Novelli, A., & On behalf of the *MASTER working group, B. O. T. MASTER. W. G. (2017). The most appropriate therapeutic strategy for acute lower respiratory tract infections: a Delphi-based approach. Journal of Chemotherapy, 29(5), 274-286.