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 - PubMed (original) (raw)

Practice Guideline

. 2019 Oct 1;200(7):e45-e67.

doi: 10.1164/rccm.201908-1581ST.

Grant W Waterer, Ann C Long, Antonio Anzueto, Jan Brozek, Kristina Crothers, Laura A Cooley, Nathan C Dean, Michael J Fine, Scott A Flanders, Marie R Griffin, Mark L Metersky, Daniel M Musher, Marcos I Restrepo, Cynthia G Whitney

• PMID: 31573350
• PMCID: PMC6812437
• DOI: 10.1164/rccm.201908-1581ST

Practice Guideline

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

Joshua P Metlay et al. Am J Respir Crit Care Med. 2019.

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.

PubMed Disclaimer

Comment in

• Summary for Clinicians: Clinical Practice Guideline for the Diagnosis and Treatment of Community-acquired Pneumonia.
  Jones BE, Herman DD, Dela Cruz CS, Waterer GW, Metlay JP, Ruminjo JK, Thomson CC. Jones BE, et al. Ann Am Thorac Soc. 2020 Feb;17(2):133-138. doi: 10.1513/AnnalsATS.201909-704CME. Ann Am Thorac Soc. 2020. PMID: 31770496 No abstract available.
• Multidisciplinary Authorship in Clinical Practice Guidelines: An Opportunity for Inclusion.
  Chahine EB. Chahine EB. Am J Respir Crit Care Med. 2020 Mar 15;201(6):743-744. doi: 10.1164/rccm.201910-1908LE. Am J Respir Crit Care Med. 2020. PMID: 31800259 Free PMC article. No abstract available.
• Viewing the Community-acquired Pneumonia Guidelines through an Antibiotic Stewardship Lens.
  Fabre V, Spivak ES, Keller SC. Fabre V, et al. Am J Respir Crit Care Med. 2020 Mar 15;201(6):745-746. doi: 10.1164/rccm.201910-2026LE. Am J Respir Crit Care Med. 2020. PMID: 31800265 Free PMC article. No abstract available.
• Reply to Chahine, to Schuetz, and to Fabre et al.
  Metlay JP, Waterer GW. Metlay JP, et al. Am J Respir Crit Care Med. 2020 Mar 15;201(6):746-747. doi: 10.1164/rccm.201910-2000LE. Am J Respir Crit Care Med. 2020. PMID: 31800266 Free PMC article. No abstract available.
• 2019 Community-acquired Pneumonia Treatment Guidelines: There Is a Need for a Change toward More Parsimonious Antibiotic Use.
  Huttner B, Cappello B, Cooke G, Gandra S, Harbarth S, Imi M, Loeb M, Mendelson M, Moja L, Pulcini C, Sharland M, Tacconnelli E, Zeng M, Magrini N. Huttner B, et al. Am J Respir Crit Care Med. 2020 May 15;201(10):1315-1316. doi: 10.1164/rccm.201911-2226LE. Am J Respir Crit Care Med. 2020. PMID: 32069065 Free PMC article. No abstract available.
• Reply to Huttner et al.: 2019 Community-acquired Pneumonia Treatment Guidelines: There Is a Need for a Change toward More Parsimonious Antibiotic Use.
  Metlay JP, Waterer GW. Metlay JP, et al. Am J Respir Crit Care Med. 2020 May 15;201(10):1316-1317. doi: 10.1164/rccm.202001-0164LE. Am J Respir Crit Care Med. 2020. PMID: 32069069 Free PMC article. No abstract available.
• Antibiotic-resistant bacteria: COVID-19 hasn't made the challenge go away.
  Waterer G, Pickens CI, Wunderink R. Waterer G, et al. Respirology. 2021 Nov;26(11):1024-1026. doi: 10.1111/resp.14166. Epub 2021 Oct 1. Respirology. 2021. PMID: 34596927 Free PMC article. No abstract available.

Similar articles

• The hospitalist perspective on treatment of community-acquired bacterial pneumonia.
  Amin AN, Cerceo EA, Deitelzweig SB, Pile JC, Rosenberg DJ, Sherman BM. Amin AN, et al. Postgrad Med. 2014 Mar;126(2):18-29. doi: 10.3810/pgm.2014.03.2737. Postgrad Med. 2014. PMID: 24685965 Review.
• Diagnosis and management of community-acquired pneumonia in adults.
  Watkins RR, Lemonovich TL. Watkins RR, et al. Am Fam Physician. 2011 Jun 1;83(11):1299-306. Am Fam Physician. 2011. PMID: 21661712
• [Comparative analysis of guidelines for the treatment of community-acquired pneumonias].
  Rodríguez de Castro F. Rodríguez de Castro F. Arch Bronconeumol. 1999 Jun;35(6):253-6. Arch Bronconeumol. 1999. PMID: 10410203 Spanish. No abstract available.
• [Management of community-acquired pneumonia in the physician's office].
  Lode HM, Erbes R, Linnhoff A. Lode HM, et al. MMW Fortschr Med. 2006 Jan 12;148(1-2):32-5. doi: 10.1007/BF03364510. MMW Fortschr Med. 2006. PMID: 16610411 German.
• Emergency management of community-acquired bacterial pneumonia: what is new since the 2007 Infectious Diseases Society of America/American Thoracic Society guidelines.
  Moran GJ, Rothman RE, Volturo GA. Moran GJ, et al. Am J Emerg Med. 2013 Mar;31(3):602-12. doi: 10.1016/j.ajem.2012.12.002. Epub 2013 Feb 4. Am J Emerg Med. 2013. PMID: 23380120

Cited by

• Impact of antibiotic changes on hospital stay and treatment duration in community-acquired pneumonia.
  Ryu J, Kim NH, Ohn JH, Lim Y, Lee J, Kim HW, Kim SW, Park HS, Kim ES, Yoon S, Heo E, Kim ES. Ryu J, et al. Sci Rep. 2024 Sep 30;14(1):22669. doi: 10.1038/s41598-024-73304-z. Sci Rep. 2024. PMID: 39349548
• Clarithromycin Modulates Neutrophilic Inflammation Induced by Prevotella intermedia in Human Airway Epithelial Cells.
  Iwanaga N, Ota A, Ashizawa H, Ito Y, Hirayama T, Yoshida M, Takeda K, Ide S, Tashiro M, Hosogaya N, Sakamoto N, Takazono T, Kosai K, Naito M, Tanaka Y, Yatera K, Izumikawa K, Yanagihara K, Mukae H. Iwanaga N, et al. Antibiotics (Basel). 2024 Sep 23;13(9):909. doi: 10.3390/antibiotics13090909. Antibiotics (Basel). 2024. PMID: 39335081 Free PMC article.
• The importance of high total body water/fat free mass ratio and serial changes in body composition for predicting hospital mortality in patients with severe pneumonia: a prospective cohort study.
  Tseng CC, Hung KY, Chang HC, Huang KT, Wang CC, Chen YM, Lin CY, Lin MC, Fang WF. Tseng CC, et al. BMC Pulm Med. 2024 Sep 27;24(1):470. doi: 10.1186/s12890-024-03302-4. BMC Pulm Med. 2024. PMID: 39333963 Free PMC article.
• Ideal Postdischarge Follow-Up After Severe Pneumonia or Acute Respiratory Failure: A Qualitative Study of Primary Care Clinicians in Diverse Settings.
  Hauschildt KE, Taylor SP, Hough CL, Hladek MD, Perrin EM, Iwashyna TJ. Hauschildt KE, et al. CHEST Crit Care. 2024 Sep;2(3):100079. doi: 10.1016/j.chstcc.2024.100079. Epub 2024 May 9. CHEST Crit Care. 2024. PMID: 39329025 Free PMC article.
• Rapid de-escalation of anti-MRSA therapy guided by S. aureus nares screening for patients with pneumonia: protocol of a randomized controlled trial (SNAP study).
  De Vita E, Segala FV, Cavallin F, Guido G, Frallonardo L, Cotugno S, Pellegrino C, Di Gennaro F, Saracino A. De Vita E, et al. Front Med (Lausanne). 2024 Sep 10;11:1416904. doi: 10.3389/fmed.2024.1416904. eCollection 2024. Front Med (Lausanne). 2024. PMID: 39318595 Free PMC article.

References

1. 1. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, 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;44:S27–S72. - PMC - PubMed
2. 1. Guyatt GH, Oxman AD, Kunz R, Atkins D, Brozek J, Vist G, et al. GRADE guidelines: 2. Framing the question and deciding on important outcomes. J Clin Epidemiol. 2011;64:395–400. - PubMed
3. 1. Metlay JP, Kapoor WN, Fine MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA. 1997;278:1440–1445. - PubMed
4. 1. Sato T, Aoshima M, Ohmagari N, Tada H, Chohnabayashi N. Usefulness of sputum Gram staining in community-acquired pneumonia [in Japanese] Nihon Kokyuki Gakkai Zasshi. 2002;40:558–563. - PubMed
5. 1. Shariatzadeh MR, Marrie TJ. Does sputum culture affect the management and/or outcome of community-acquired pneumonia? East Mediterr Health J. 2009;15:792–799. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • Atypon
  • Europe PubMed Central
  • Ovid Technologies, Inc.
  • PubMed Central

• Other Literature Sources

  • H1 Connect
  • The Lens - Patent Citations

• Medical

  • MedlinePlus Health Information