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Highlights & Basics
- Community-acquired pneumonia (CAP) is typically characterized by a new lung infiltrate on chest x-ray, together with one or more of the following: fever, chills, cough, sputum production, dyspnea, myalgia, arthralgia, pleuritic pain.
- Order a chest x-ray in all patients with suspected CAP who are admitted to hospital to confirm or exclude diagnosis.
- Order sputum and blood cultures in all hospitalized patients treated empirically for methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa, as well as in patients with severe CAP.
- Use a validated clinical prediction rule for prognosis (e.g., Pneumonia Severity Index), along with clinical judgment, to determine whether the patient should be treated as an inpatient or outpatient.
- Treat with empiric antibiotics. Broader-spectrum regimens are required in patients with comorbidities. Add antibiotic cover for MRSA and P aeruginosa if locally validated risk factors for either pathogen are present.
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