Treatment of community-acquired pneumonia in adults in the outpatient setting
- Thomas M File, Jr, MD
Thomas M File, Jr, MD
- Professor of Medicine
- Northeast Ohio Medical University
Community-acquired pneumonia (CAP) is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia (HAP).
CAP is a common and potentially serious illness [1-4]. It is associated with considerable morbidity and mortality, particularly in older adult patients and those with major comorbidities. (See "Prognosis of community-acquired pneumonia in adults".)
The treatment of CAP in adults in the outpatient setting will be reviewed here. A variety of other important issues related to CAP are discussed separately. These include:
●The diagnostic approach to patients with CAP. (See "Diagnostic approach to community-acquired pneumonia in adults".)
●How one makes the decision to admit patients with CAP to the hospital. (See "Community-acquired pneumonia in adults: Risk stratification and the decision to admit".)
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- MANAGEMENT OF HEALTHCARE-ASSOCIATED PNEUMONIA
- INDICATIONS FOR HOSPITALIZATION
- PRINCIPLES OF ANTIMICROBIAL THERAPY
- Establishing the diagnosis
- Empiric therapy
- Common pathogens
- Risk factors for drug resistance
- Caveats for fluoroquinolones and macrolides
- North America
- United Kingdom
- Coverage of atypical pathogens
- TREATMENT REGIMENS
- No comorbidities, no recent antibiotic use
- - Low rate (<25 percent) of macrolide resistance
- - High rate (≥25 percent) of macrolide resistance (includes United States)
- Comorbidities or recent antibiotic use
- Pathogen-directed therapy
- Treatment duration and response
- Clinical follow-up
- Follow-up chest radiograph
- The nonresponding patient
- SMOKING CESSATION
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS