Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia

The Pneumonia Severity Index (PSI) and CURB-65 decision aids can support clinical judgement by identifying patients at low risk of mortality who may be appropriate for outpatient treatment. Although both decision aids are acceptable, the PSI is supported by a larger body of evidence and is preferred by other society guidelines (ATS/IDSA 2019 guidelines).
(Level B recommendation)

Among patients not receiving vasopressors or mechanical ventilation, use the 2007 IDSA/ATS Minor Criteria rather than mortality prediction aids such as the PSI or CURB-65 to help establish which patients are most appropriate for care based in an ICU setting
(Consensus recommendation. Level C recommendation.)

Do not routinely use biomarkers to augment the performance of clinical decision aids to guide the disposition of ED patients with CAP
(Consensus recommendation). Level C recommendation.)

Use CAP clinical decision aids in conjunction with physician clinical judgment in the context of each patient’s circumstances when making disposition decisions.
(Consensus recommendation) Level C recommendation.)