Dr. Ronald F. GrossmanProfessor of Medicine
Ronald F. Grossman is Professor of Medicine, University of Toronto, and previous Chief of Medicine, Credit Valley Hospital.
Ronald F. Grossman is Professor of Medicine, University of Toronto and previous Chief of Medicine, Credit Valley Hospital, Mississauga, Ontario, Canada.He has published over 90 articles in a wide number of medical journals including New England Journal of Medicine, American Journal of Respiratory Critical Care Medicine, American Journal of Medicine and Chest. His major research and teaching interests are in respiratory tract infections. He has participated in the creation of Canadian and American guidelines for the management of community-acquired pneumonia, Canadian guidelines for the management of hospital-acquired pneumonia and Canadian and international guidelines for the management of acute exacerbations of chronic obstructive lung disease.He previously served as the chairman of the National Information Program on Antibiotics (NIPA), a coalition of many medical and public health societies. This coalition was established to encourage the appropriate use of antibiotics among physicians and patients.He recently was awarded the Murray Kornfeld Memorial Founder’s Lectureship by the American College of Chest Physicians.
Community-acquired pneumonia (CAP) and tuberculosis (TB) both continue to cause considerable morbidity, hospitalization and mortality worldwide. In patients presenting with a lower respiratory tract infection (LRTI), prompt and accurate differential diagnosis of CAP and TB is important, but not straightforward; clinical and chest image assessments are key. The high bacteriological and clinical efficacy of respiratory fluoroquinolones, such as moxifloxacin, underpins the importance of these antibiotics in the management of CAP.
Community-acquired pneumonia and tuberculosis: differential diagnosis and the use of fluoroquinolonesInternational Journal of Infectious Diseases
The respiratory fluoroquinolones moxifloxacin, gemifloxacin, and high-dose levofloxacin are recommended in guidelines for effective empirical antimicrobial therapy of community-acquired pneumonia (CAP). The use of these antibiotics for this indication in areas with a high prevalence of tuberculosis (TB) has been questioned due to the perception that they contribute both to delays in the diagnosis of pulmonary TB and to the emergence of fluoroquinolone-resistant strains of Mycobacterium tuberculosis.
In certain parts of the United States and Canada, and northern Ontario in particular, the dimorphic fungus Blastomyces dermatitidis is endemic and can cause infection in exposed individuals. The site of infection is usually pulmonary, causing respiratory and constitutional symptoms, but can also affect other sites in the body. Symptom severity can vary substantially from no symptoms to fatal acute respiratory distress syndrome.
Frequent exacerbations of COPD are associated with accelerated loss of lung function, declining health status, increased mortality, and increased health care costs. Thus, a key objective in the management of COPD is preventing exacerbations or at least reducing their number and severity. When new interventions are examined, their value is sometimes assessed in reference to the minimal clinically important difference (MCID), a theoretical construct that may be defined and estimated numerically in several different ways.
Estimates of the disease burden from childhood pneumonia are available for most developed countries, but they are based mainly on models. Measured country-specific pneumonia burden data are limited to a few nations and differ in case definitions and case ascertainment methods. This review describes pneumonia disease burden in developed countries.
Area of Expertise
Royal College of Physicians and Surgeons of Canada : Fellow
Ontario Medical Association : Member
Ontario Thoracic Society : Member
American Thoracic Society : Member
American College of Physicians : Fellow
University of Toronto :