Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST.

Abstract

Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia.Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations.Results: The panel addressed 16 specific areas for recommendations spanning questions of diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions.Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.

Keywords: community-acquired pneumonia; pneumonia; patient management.

Publication types

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

MeSH terms

  • Adult
  • Ambulatory Care
  • Anti-Bacterial Agents / therapeutic use*
  • Antigens, Bacterial / urine
  • Blood Culture
  • Chlamydophila Infections / diagnosis
  • Chlamydophila Infections / drug therapy
  • Chlamydophila Infections / metabolism
  • Community-Acquired Infections / diagnosis*
  • Community-Acquired Infections / drug therapy*
  • Culture Techniques
  • Drug Therapy, Combination
  • Haemophilus Infections / diagnosis
  • Haemophilus Infections / drug therapy
  • Haemophilus Infections / metabolism
  • Hospitalization
  • Humans
  • Legionellosis / diagnosis
  • Legionellosis / drug therapy
  • Legionellosis / metabolism
  • Macrolides / therapeutic use
  • Moraxellaceae Infections / diagnosis
  • Moraxellaceae Infections / drug therapy
  • Moraxellaceae Infections / metabolism
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Mycoplasma / diagnosis
  • Pneumonia, Mycoplasma / drug therapy
  • Pneumonia, Mycoplasma / metabolism
  • Pneumonia, Pneumococcal / diagnosis
  • Pneumonia, Pneumococcal / drug therapy
  • Pneumonia, Pneumococcal / metabolism
  • Pneumonia, Staphylococcal / diagnosis
  • Pneumonia, Staphylococcal / drug therapy
  • Pneumonia, Staphylococcal / metabolism
  • Radiography, Thoracic
  • Severity of Illness Index
  • Sputum
  • United States
  • beta-Lactams / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Antigens, Bacterial
  • Macrolides
  • beta-Lactams