Emergency management of community-acquired bacterial pneumonia: what is new since the 2007 Infectious Diseases Society of America/American Thoracic Society guidelines

• Published in: The American journal of emergency medicine 2013-03, Vol.31 (3), p.602-612
• Main Authors: Moran, Gregory J., MD, Rothman, Richard E., MD, PhD, Volturo, Gregory A., MD
• Format: Article
• Language: English
• Subjects: Ambulatory care; Anti-Bacterial Agents - therapeutic use; Antibiotics; Antimicrobial agents; Bacterial infections; Community-Acquired Infections - diagnosis; Community-Acquired Infections - microbiology; Community-Acquired Infections - therapy; Costs; Critical Care; Decision Support Techniques; Emergency; Emergency medical care; Emergency medical services; Emergency preparedness; Emergency Treatment - methods; Health care; Health care policy; Hospitalization; Hospitals; Humans; Infectious diseases; Mortality; Patients; Physicians; Pneumonia; Pneumonia, Bacterial - diagnosis; Pneumonia, Bacterial - microbiology; Pneumonia, Bacterial - therapy; Pneumonia, Pneumococcal - diagnosis; Pneumonia, Pneumococcal - therapy; Pneumonia, Staphylococcal - diagnosis; Pneumonia, Staphylococcal - therapy; Practice Guidelines as Topic; Severity of Illness Index; Society; Staphylococcus aureus; Streptococcus infections; United States
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2012.12.002

Abstract Community-acquired pneumonia (CAP) is a major health problem in the United States and is associated with substantial morbidity, mortality, and health care costs. Patients with CAP commonly present to emergency departments where physicians must make critical decisions regarding diagnosis and management of pneumonia in a timely fashion, with emphasis on efficient and cost-effective diagnostic choices, consideration of emerging antimicrobial resistance, timely initiation of antibiotics, and appropriate site-of-care decisions. In light of the burden that pneumonia places on health care systems and the emergency department in particular, this article reviews significant developments in the management of CAP in the United States 5 years since the publication of the 2007 Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of CAP in adults, focusing on recent studies and recommendations for managing CAP, the primary bacterial pathogens responsible for CAP, and trends in resistance, new diagnostic technologies, and newer antimicrobials approved for the treatment of CAP. These new data and additional guidelines pertaining to the treatment of CAP further our knowledge and understanding of this challenging infection. Furthermore, appreciation of the availability of new diagnostic testing and therapeutic options will help meet the demand for improved management of CAP.