Diagnosis and Treatment of Adults with Community-Acquired Pneumonia
Publication Date: October 1, 2019
Last Updated: December 15, 2022
Diagnosis
1. Gram Stain
We recommend NOT obtaining sputum Gram stain and culture routinely in adults with CAP managed in the outpatient setting. (S, VL)
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We recommend obtaining pretreatment Gram stain and culture of respiratory secretions in adults with CAP managed in the hospital setting who:
1. are classified as severe CAP (see Table 1), especially if they are intubated or (S, VL)
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2.a. are being empirically treated for MRSA or P. aeruginosa (strong recommendation, very low quality of evidence) or (S, VL)
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2.b. were previously infected with MRSA or P. aeruginosa, especially those with prior respiratory tract infection (conditional recommendation, very low quality of evidence) or (C, VL)
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2.c. were hospitalized and received parenteral antibiotics in the last 90 days. (C, VL)
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Treatment
5. Procalcitonin
We recommend that empiric antibiotic therapy should be initiated in adults with clinically suspected and radiographically confirmed CAP regardless of initial serum procalcitonin level. (S, M)
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Title
Diagnosis and Treatment of Adults with Community-Acquired Pneumonia
Authoring Organizations
American Thoracic Society
Infectious Diseases Society of America