Fayos M, Bouza E, Burillo A, Galar A, Álvarez-Uría A, Muñoz P. A rapid surveillance of pneumonia in hospitalized patients: an opportunity for intervention. Rev Esp Quimioter 2026; 39(1): 39-48. Available from: http://doi.org/10.37201/req/104.2025.

Antimicrobial resistance claimed an estimated 4.95 million lives in 2019. When clinicians prescribe empiric therapy that follows guidelines, mortality drops by roughly a third; when they de-escalate on the basis of culture results, it drops by more than half. Yet the document that should drive both decisions, the antibiogram, is often read superficially or misinterpreted, particularly by physicians without infectious-disease training. Existing stewardship frameworks address prescribing principles, timing, or ecological impact, but none walks the clinician step by step through an individual susceptibility report and out the other side with a treatment plan. PRECISE is a seven-step mnemonic designed for that purpose. Each letter corresponds to a clinical action: Pathogen assessment, Resistance phenotype interpretation, Evaluate MIC, Curtail spectrum, Individualize PK/PD, Switch route, and Endpoint optimization. Three clinical vignettes (including one in which the steps deliberately collide) illustrate how the framework operates in practice.

Hantaviruses are rodent-borne zoonotic RNA viruses with a worldwide distribution and the capacity to cause severe human disease. More than 40 hantavirus species have been identified, of which over 20 are known to be pathogenic to humans. Old World hantaviruses are classically associated with Hemorrhagic Fever with Renal Syndrome (HFRS), whereas New World hantaviruses predominantly cause Hantavirus Cardiopulmonary Syndrome (HCPS), a condition characterized by rapid progression to respiratory failure, shock, and substantial mortality. Human infection is usually acquired through the inhalation of aerosols contaminated with excreta from infected reservoir animals, primarily rodents, although person-to-person transmission has been demonstrated for the Andes virus. This review summarizes current knowledge on hantavirus biology, reservoirs, transmission, epidemiology, clinical manifestations, laboratory diagnosis, treatment, prognosis, and prevention, with particular emphasis on the situation in Spain. Worldwide, hantavirus infections remain underdiagnosed because many cases are asymptomatic or present with nonspecific clinical manifestations. Diagnosis relies mainly on serological and molecular methods. No universally effective antiviral therapy is currently available for hantavirus disease, and management remains largely supportive, with intensive care and extracorporeal membrane oxygenation playing a crucial role in severe cases. Evidence accumulated over the last three decades confirms the circulation of hantaviruses in Spain, both in animal reservoirs and in humans. Although clinically recognized disease remains uncommon, serological and ecological studies demonstrate that these infections are present in the country. Continued surveillance, improved diagnostic awareness, and the development of effective preventive and therapeutic strategies remain important public health priorities.