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PNEUMONIA - COMMUNITY-ACQUIRED
Treatment Guideline Chart
Community-Acquired Pneumonia (CAP) is an acute infection of the pulmonary parenchyma accompanied by symptoms of acute illness and abnormal chest findings.
It is a lower respiratory tract infection acquired in the community within 24 hours to <2 weeks or occurring ≤48 hours of hospital admission in patients who do not meet the criteria for healthcare-associated pneumonia.
It occurs at the highest rates in the very young and the very old.
Potentially life-threatening especially in older adults and those with comorbid disease.

Pneumonia - Community-Acquired References

  1. Anand N, Kollef MH. The alphabet soup of pneumonia: CAP, HAP, HCAP, NHAP, and VAP. Semin Respir Crit Care Med. 2009 Feb;30(1):3-9. doi: 10.1055/s-0028-1119803. PMID: 19199181
  2. British Thoracic Society Standards of Care Committee. BTS Guidelines for the management of community acquired pneumonia in adults. Thorax. 2001 Dec;56(4)(Suppl 1):iv1-iv64. http://www.ncbi.nlm.nih.gov/. PMID: 11713364
  3. Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV 23). MMWR Morb Mortal Wkly Rep. 2010 Sep;59(34):1102-1106. Accessed 06 Apr 2011. PMID: 20814406
  4. Carbonara S, Monno L, Longo B, et al. Community-acquired pneumonia. Curr Opin Pulm Med. 2009 May;15(3):261-273. doi: 10.1097/MCP.0b013e3283287c3f. PMID: 19387263
  5. File TM. The science of selecting antimicrobials for community-acquired pneumonia (CAP). J Manag Care Pharm. 2009 Mar;15(Suppl 2):S5-S11. doi: 10.18553/jmcp.2009.15.s2.5. PMID: 19236135
  6. Garcia-Vidal C, Carratalà J. Early and late treatment failure in community-acquired pneumonia. Mar 18, 2009. Semin Respir Crit Care Med. 2009 Apr;30(2):154-160. doi: 10.1055/s-0029-1202934. PMID: 19296415
  7. Lee RW, Lindstrom ST. Early switch to oral antibiotics and early discharge guidelines in the management of community-acquired pneumonia. Respirology. 2007 Jan;12(1):111-116. doi: 10.1111/j.1440-1843.2006.00931.x. PMID: 17207035
  8. Lode HM. Managing community-acquired pneumonia: a European perspective. Respir Med. 2007 Sep;101(9):1864-1873. doi: 10.1016/j.rmed.2007.04.008. PMID: 17548187
  9. Liam CK, Pang YK, Poosparajah S, et al. Community-acquired pneumonia: an Asia Pacific perspective. Respirology. 2007 Mar;12(2):162-164. doi: 10.1111/j.1440-1843.2006.01013.x. PMID: 17298446
  10. Mandell LA, Wunderink RG, Anzueto A, et al; Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society Consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar;44(Suppl 2):S27-S72. http://www.ncbi.nlm.nih.gov/pubmed/17278083. PMID: 17278083
  11. Lutfiyya MN, Henley E, Chang LF, et al. Diagnosis and treatment of community-acquired pneumonia. Am Fam Physician. 2006 Feb;73(3):442-450. http://www.aafp.org/. PMID: 16477891
  12. Ramsdell J, Narsavage GL, Fink JB; American College of Chest Physicians' Home Care Network Working Group. Management of community-acquired pneumonia in the home: an American College of Chest Physicians clinical position statement. Chest. 2005 May;127(5):1752-1763. http://www.ncbi.nlm.nih.gov/. PMID: 15888856
  13. Woodhead M. The European vision of community-acquired pneumonia. Mar 18, 2009. Semin Respir Crit Care Med. 2009 Apr;30(2):136-145. http://www.ncbi.nlm.nih.gov/. PMID: 19296413
  14. Shorr AF, Owens RC Jr. Guidelines and quality for community-acquired pneumonia: measures from the Joint Commission and the Centers for Medicare and Medicaid Services. Am J Health Syst Pharm. 2009 Jun;66(12)(Suppl 4):S2-S7. doi: 10.2146/090087a. PMID: 19502224
  15. World Health Organization. Guidelines for the management of common illnesses with limited resources. Pocket book of hospital care for children. Geneva, Switzerland: World Health Organization; 2005.
  16. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  17. MedWormhttp://www.medworm.com/rss/index.php/Respiratory-Medicine/40/http://www.medworm.com/rss/medicalfeeds/specialities/Respiratory-Medicine.xml
  18. Ministry of Health Singapore. Clinical practice guidelines: use of antibiotics in adults. MOH (Singapore). http://www.moh.gov.sg/. Feb 2006.
  19. BTS Standards of Care Committee. BTS Guidelines for the management of community acquired pneumonia in adults. Update 2004. British Thoracic Society. http://www.brit-thoracic.org.uk/. 20 Jan 2004.
  20. Joint Statement of the Philippine Society of Microbiology and Infectious Diseases, Philippine College of Chest Physicians, Philippine Academy of Family Physicians, and Philippine College of Radiology. Philippine clinical practice guidelines on the diagnosis, empiric management, and prevention of community-acquired peumonia (CAP) in immunocompetent adults. Updated 2010. Philippine Society of Microbiology and Infectious Diseases. http://www.psmid.org.ph/. 2010.
  21. Alberta Medical Association. The diagnosis and management of community acquired pneumonia: pediatric. Alberta Medical Association. http://www.topalbertadoctors.org/. 2006.
  22. National Institute for Health and Care Excellence. Pneumonia: diagnosis and management of community- and hospital-acquired pneumonia in adults. NICE clinical guideline 191. NICE. http://www.nice.org.uk/. Dec 2014. Accessed 21 Apr 2015.
  23. Community-acquired Pneumonia Task Force 2016; Joint Statement of the Philippine Society of Microbiology and Infectious Diseases, Philippine College of Chest Physicians, Philippine Academy of Family Physicians, and Philippine College of Radiology. Philippine clinical practice guidelines on the diagnosis, empiric management and prevention of community-acquired pneumonia in immunocompetent adults: 2016 update; treatment. Philippine Academy of Family Physicians. http://thepafp.org/. 2016.
  24. Kim DK, Riley LE, Harriman KH, et al. Advisory Committee on Immunization Practices Recommended immunization schedule for adults aged 19 years or older - United States, 2017. MMWR Morb Mortal Wkly Rep. 2017 Feb;66(5):136-138. doi: 10.15585/mmwr.mm6605e2. Accessed 19 Jul 2017. PMID: 28182599
  25. Marrie TJ, File TM. Epidemiology, pathogenesis, and microbiology of community-acquired pneumonia in adults. UpToDate. https://www.uptodate.com/. Feb 2017. Accessed 19 Jul 2017.
  26. Centers for Disease Control and Prevention (CDC). Recommended immunization schedule for adults aged 19 years or older, United States, 2018. CDC. https://www.cdc.gov/. Feb 2018. Accessed 03 Apr 2018.
  27. Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016 Sep;63(5):e61-e111. doi: 10.1093/cid/ciw353. Accessed 04 Jul 2019. PMID: 27418577
  28. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997 Jan;336(4):243-250. doi: 10.1056/NEJM199701233360402. PMID: 8995086
  29. Ramirez JA. Overview of community-acquired pneumonia in adults. UpToDate. https://www.uptodate.com/. May 2019. Accessed 04 Jul 2019.
  30. Yearly DM, Fine MJ. Community-acquired pneumonia in adults: Assessing severity and determining the appropriate site of care. UpToDate. https://www.uptodate.com/. May 2019. Accessed 04 Jul 2019.
  31. File TM. Treatment of community-acquired pneumonia in adults in the outpatient setting. UpToDate. https://www.uptodate.com/. Jan 2019. Accessed 11 Jul 2019.
  32. British Thoracic Society Community-Acquired Pneumonia Guideline Working Group. 2015 - Annotated BTS guideline for the management of CAP in adults (2009) summary recommendations. British Thoracic Society. https://www.brit-thoracic.org.uk/. Jan 2015. Accessed 3 Oct 2019.
  33. Chou CC, Shen CF, Chen SJ, et al; Infectious Diseases Society of Taiwan; Taiwan Society of Pulmonary and Critical Care Medicine; Medical Foundation in Memory of Dr. Deh-Lin Cheng; Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education; CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines; 4th Guidelines Recommendations for Evidence-based Antimicrobial agents use in Taiwan (GREAT) working group. Recommendations and guidelines for the treatment of pneumonia in Taiwan. J Microbiol Immunol Infect. 2019 Feb;52(1):172-199. doi: 10.1016/j.jmii.2018.11.004. Accessed 3 Oct 2019. PMID: 30612923
  34. Metlay JP, Waterer GW, Long AC, et al. 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;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. PMID: 31573350
  35. National Institute for Health and Clinical Excellence. Pneumonia (community-acquired): antimicrobial prescribing. NICE. https://www.nice.org.uk/. Feb 2019. Accessed 3 Oct 2019.
  36. Bartlett JG. Diagnostic approach to community-acquired pneumonia in adults. UpToDate. https://www.uptodate.com/. Sep 2019.
  37. Torres A, Lee N, Cilloniz C, et al. Laboratory diagnosis of pneumonia in the molecular age. Eur Respir J. 2016 Dec;48(6):1764-1778. doi: 10.1183/13993003.01144-2016. Accessed 14 Oct 2019. PMID: 27811073
  38. Bartlett JG. Diagnostic approach to community-acquired pneumonia in adults. UpToDate. https://www.uptodate.com. 02 Dec 2019. Accessed 11 Aug 2020.
  39. File TM Jr. Epidemiology, pathogenesis, and microbiology of community-acquired pneumonia in adults. UpToDate. https://www.uptodate.com. 02 Jul 2020. Accessed 11 Aug 2020.
  40. File TM Jr. Treatment of community acquired pneumonia in adults in the outpatient setting. UpToDate. https://www.uptodate.com. 25 Nov 2019.
  41. File TM Jr. Treatment of community acquired pneumonia in adults who require hospitalization. UpToDate. https://www.uptodate.com. 10 Jul 2020.
  42. Hill AT, Gold PM, El Solh AA, et al. Adult outpatients with acute cough due to suspected pneumonia or influenza: CHEST guideline and Expert Panel report. CHEST. 2019 Jan;155(1):155-167. doi: 10.1016/j.chest.2018.09.016. PMID: 30296418
  43. Kaysin A, Viera AJ. Community-acquired pneumonia in adults: diagnosis and management. Am Fam Physician. 2016 Nov;94(9):698-706. Accessed 11 Aug 2020. PMID: 27929242
  44. Ramirez JA. Overview of community-acquired pneumonia in adults. UpToDate. https://www.uptodate.com. 13 Mar 2020.
  45. Yealy DM, Fine MJ. Community-acquired pneumonia in adults: assessing severity and determining the appropriate site of care. UpToDate. https://www.uptodate.com. 03 Oct 2019. Accessed 11 Aug 2020.
  46. Global Initiative for Asthma (GINA). Interim guidance about COVID-19 and asthma. GINA. https://ginasthma.org/. 20 Dec 2020. Accessed 3 Feb 2021.
  47. Akuzawa N, Naito H. Nutritional parameters affecting severity of pneumonia and length of hospital stay in patients with pneumococcal pneumonia: a retrospective cross-sectional study. BMC Pulm Med. 2015 Nov;15:149. doi: 10.1186/s12890-015-0143-7. PMID: 26608261
  48. Almirall J, Serra-Prat M, Bolíbar I, et al. Risk factors for community-acquired pneumonia in adults: A systematic review of observational studies. Respiration. 2017 Jul;94(3):299-311. doi: 10.1159/000479089. Accessed 16 Feb 2021. PMID: 28738364
  49. Centers for Disease Control and Prevention. Pneumonia. CDC. https://www.cdc.gov/. Oct 2020.
  50. Dadonaite B. Pneumonia. OurWorldInData.org. https://ourworldindata.org/pneumonia. 2018.
  51. Ferreira-Coimbra J, Sarda C, Rello J. Burden of community-acquired pneumonia and unmet clinical needs. Adv Ther. 2020 Apr;37(4):1302-1318. doi: 10.1007/s12325-020-01248-7. PMID: 32072494
  52. Kang DR, Kim YK, Park MS, et al. Low levels of serum cholesterol and albumin and the risk of community-acquired pneumonia in young soldiers. Int J Tuberc Lung Dis. 2008 Jan;12(1):26-32. Accessed 16 Feb 2021. PMID: 18173873
  53. Narita M. Classification of extrapulmonary manifestations due to Mycoplasma pneumoniae Infection on the basis of possible pathogenesis. Front Microbiol. 2016 Jan;7:23. doi: 10.3389/fmicb.2016.00023. PMID: 26858701
  54. Sattar SBA, Sharma S. Bacterial pneumonia. StatPearls [Internet]: Treasure Island (FL): StatPearls Publishing; 2020 Nov.
  55. Song JH, Huh K, Chung DR. Community-acquired pneumonia in the Asia-Pacific region. Semin Respir Crit Care Med. 2016 Dec;37(6):839-854. doi: 10.1055/s-0036-1592075. PMID: 27960208
  56. Watkins RR, Lemonovich TL. Diagnosis and management of community-acquired pneumonia in adults. Am Fam Physician. 2011 Jun;83(11):1299-1306. PMID: 21661712
  57. Berman-Rosa M, O'Donnell S, Barker M, Quach C. Efficacy and effectiveness of the PCV-10 and PCV-13 vaccines against invasive pneumococcal disease. Pediatrics. 2020 Apr;145(4):e20190377. doi: 10.1542/peds.2019-0377. PMID: 32156773
  58. Malaysian Health Technology Assessment Section (MaHTAS). Pneumococcal conjugate vaccine for children below five years old. Ministry of Health Malaysia. https://www.moh.gov.my/. 2020.
  59. Yealy DM, Fine MJ. Community-acquired pneumonia in adults; Assessing severity and determining the appropriate site of care . UpToDate. https://www.uptodate.com/. 19 Apr 2021.
  60. Dockrell DH, Ho A, Gordon SB. Community-Acquired Pneumonia. In: Broaddus VC, eds. Murray & Nadel's Textbook of Respiratory Medicine. 7th. PA: Elsevier; 2022. https://www.clinicalkey.com/.
  61. Centers for Disease Control and Prevention (CDC). Legionella (Legionnaire’s disease and Pontiac fever). CDC. https://www.cdc.gov/. 25 Mar 2021.
  62. Lee CC, Kwa ALH, Apisarnthanarak A, et al. Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: adaptation based on an expert consensus meeting. Clin Chem Lab Med. 2020 Nov;58(12):1983-1991. doi: 10.1515/cclm-2019-1122. PMID: 31926074
  63. Murdoch D, Chambers ST. Treatment and prevention of Legionella infection. UpToDate. https://www.uptodate.com/. 04 Apr 2022.
  64. Schuetz P, Beishuizen A, Broyles M, et al. Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use. Clin Chem Lab Med. 2019 Aug;57(9):1308-1318. doi: 10.1515/cclm-2018-1181. PMID: 30721141
  65. Olson G, Davis AM. Diagnosis and treatment of adults with community-acquired pneumonia. JAMA. 2020 Mar;323(9):885-886. doi: 10.1001/jama.2019.21118. PMID: 32027358
  66. Kobayashi M, Farrar JL, Gierke R, et al. Use of 15-valent pneumococcal conjugate vaccine and 20-valent pneumococcal conjugate vaccine among U.S. adults: Updated recommendations of the Advisory Committee on Immunization Practices — United States, 2022. MMWR. 2022;71(4):109-117. https://www.cdc.gov/.
  67. Musher DM, Rodriguez-Barradas MC. Pneumococcal vaccination in adults. UpToDate. https://www.uptodate.com/. 31 Aug 2022.
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