Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults

Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults

2000;31:347–82 | John G. Bartlett, Scott F. Dowell, Lionel A. Mandell, Thomas M. File, Jr., Daniel M. Musher, and Michael J. Fine
The guidelines for the management of community-acquired pneumonia (CAP) in adults, issued by the Infectious Diseases Society of America (IDSA), provide a comprehensive framework for clinical decision-making. The guidelines emphasize the importance of chest radiography in establishing the diagnosis and distinguishing pneumonia from acute bronchitis. Hospitalization decisions are based on a clinical prediction rule that stratifies patients into five severity classes, with risk classes I and II typically requiring outpatient treatment, class III requiring brief hospitalization, and classes IV and V requiring hospitalization. Laboratory tests, including complete blood cell count, serum creatinine, blood urea nitrogen, glucose, electrolytes, liver function tests, and HIV serology, are recommended for all hospitalized patients. Empirical antibiotic selection is guided by severity of illness, pathogen probabilities, resistance patterns, and comorbid conditions. Specific pathogens, such as *Streptococcus pneumoniae* and *Legionella*, are discussed, along with their clinical significance and treatment options. The guidelines also address the role of specific pathogens in CAP, emphasizing the importance of etiologic diagnosis for better management and outcomes. Performance indicators, such as timely blood culture collection and antibiotic initiation, are recommended to improve patient care and reduce antibiotic resistance.The guidelines for the management of community-acquired pneumonia (CAP) in adults, issued by the Infectious Diseases Society of America (IDSA), provide a comprehensive framework for clinical decision-making. The guidelines emphasize the importance of chest radiography in establishing the diagnosis and distinguishing pneumonia from acute bronchitis. Hospitalization decisions are based on a clinical prediction rule that stratifies patients into five severity classes, with risk classes I and II typically requiring outpatient treatment, class III requiring brief hospitalization, and classes IV and V requiring hospitalization. Laboratory tests, including complete blood cell count, serum creatinine, blood urea nitrogen, glucose, electrolytes, liver function tests, and HIV serology, are recommended for all hospitalized patients. Empirical antibiotic selection is guided by severity of illness, pathogen probabilities, resistance patterns, and comorbid conditions. Specific pathogens, such as *Streptococcus pneumoniae* and *Legionella*, are discussed, along with their clinical significance and treatment options. The guidelines also address the role of specific pathogens in CAP, emphasizing the importance of etiologic diagnosis for better management and outcomes. Performance indicators, such as timely blood culture collection and antibiotic initiation, are recommended to improve patient care and reduce antibiotic resistance.
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[slides and audio] Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults