> Pneumonia

Community-Acquired Pneumonia

Official guideline from the American College of Emergency Physicians.

summary by Eric Steinberg, DO

Recommendations

Diagnosis

Do not routinely obtain blood cultures in patients admitted with community-acquired pneumonia (CAP).

Level B

Consider obtaining blood cultures in higher-risk patients admitted with community-acquired pneumonia (CAP) (eg, severe disease, immunocompromise, significant comorbidities, or other risk factors for infection with resistant organisms).

Level C

Intervention

There is insufficient evidence to establish a benefit in mortality or morbidity from antibiotics administered in less than 4, 6, or 8 hours from emergency department (ED) arrival.

Level B

Administer antibiotics as soon as feasible once the diagnosis of community-acquired pneumonia (CAP) is established; there is insufficient evidence to establish a benefit in morbidity or mortality from antibiotics administered within any specific time course.

Level C

What do the icons mean?

Level A

Generally accepted principles for patient management that reflect a high degree of clinical certainty (ie, based on strength of evidence Class I or overwhelming evidence from strength of evidence Class II studies that directly address all of the issues).

Level B

Recommendations for patient management that may identify a particular strategy or range of management strategies that reflect moderate clinical certainty (ie, based on strength of evidence Class II studies that directly address the issue, decision analysis that directly addresses the issue, or strong consensus of strength of evidence Class III studies).

Level C

Other strategies for patient management that are based on preliminary, inconclusive, or conflicting evidence, or in the absence of any published literature, based on panel consensus.

Literature

Original/Primary Reference

Nazarian DJ, Eddy OL, Lukens TW, et al. American College of Emergency Physicians. Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia. Ann Emerg Med. 2009;54(5):704-31.

Calc Function

Recommendations