Epidemiology, microbiology, and treatment considerations for bacterial pneumonia complicating influenza

Int J Infect Dis. 2012 May;16(5):e321-31. doi: 10.1016/j.ijid.2012.01.003. Epub 2012 Mar 2.


Post-influenza bacterial pneumonia is a major cause of morbidity and mortality associated with both seasonal and pandemic influenza virus illness. However, despite much interest in influenza and its complications in recent years, good clinical trial data to inform clinicians in their assessment of treatment options are scant. This paucity of evidence needs to be addressed urgently in order to improve guidance on the management of post-influenza bacterial pneumonia. The objectives of the current article are to evaluate the emergence of the 2009 H1N1 influenza pandemic and use this information as background for an in-depth review of the epidemiology of bacterial pneumonia complicating influenza, to review the bacterial pathogens most likely to be associated with post-influenza bacterial pneumonia, and to discuss treatment considerations in these patients. When determining optimal management approaches, both antiviral and antibacterial agents should be considered, and their selection should be based upon a clear understanding of how their mechanisms of action intervene in the pathogenesis of post-influenza acute bacterial pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Humans
  • Influenza, Human / complications*
  • Influenza, Human / drug therapy
  • Influenza, Human / mortality
  • Pandemics
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / etiology*
  • Pneumonia, Bacterial / microbiology
  • Pneumonia, Bacterial / mortality
  • Practice Guidelines as Topic
  • Risk Factors


  • Anti-Bacterial Agents
  • Antiviral Agents