The updated guidelines do not recommend routine collection of sputum Gram stain and culture or blood cultures in CAP patients who are treated in the outpatient setting. Notably, the guidelines have eliminated the term healthcare-associated pneumonia, instead emphasizing the use of local epidemiology and risk factors to determine the need for coverage of drug-resistant pathogens, such as methicillin-resistant S aureus (MRSA) and Pseudomonas aeruginosa.

The basis for this recommendation is that no rapid and specific diagnostic test exists to confirm that a patient’s illness is due solely to a virus at the time of presentation, and patients with CAP caused by a virus often have a bacterial coinfection. Although viral pathogens are becoming an increasingly common cause of CAP, the new guidelines recommend that all patients with CAP be treated empirically for bacterial infection. The most common bacterial causes of CAP are Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Staphylococcus aureus, Legionella species, Chlamydia pneumoniae, and Moraxella catarrhalis. 4 This article presents an overview of these guidelines and reviews the etiology of CAP and antimicrobial treatment options in both the outpatient and the inpatient setting. 3 In 2019, in order to foster timely and accurate treatment, the Infectious Diseases Society of America and the American Thoracic Society jointly published guidelines for the management of immunocompetent adults with CAP. annually, with about one in three CAP patients dying within 1 year.

2 A recent study projected that CAP results in 1.5 million hospitalizations of adults in the U.S. 1 In 2016, pneumonia was the primary diagnosis in more than 1.7 million patient visits to emergency departments in the United States. Pharmacists should work actively with physicians to recommend appropriate antimicrobial therapy for the treatment of patients with CAP and are in a key position to ensure that patients receive the appropriate duration of therapy.Ĭommunity-acquired pneumonia (CAP), an infection of the lung parenchyma that occurs in persons outside of a hospital setting, is associated with high morbidity and mortality. The recommended duration of antimicrobial treatment for patients with CAP is a minimum of 5 days. Different treatment regimens are recommended depending on whether the patient is receiving treatment in the inpatient or outpatient setting, the severity of the pneumonia, and whether the patient has comorbidities or any risk factors for drug-resistant pathogens. ABSTRACT: In 2019, guidelines for the management of immunocompetent adults with community-acquired pneumonia (CAP) were published jointly by the American Thoracic Society and the Infectious Diseases Society of America.

Sanford guide to antimicrobial tx