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CURB-65 Score for Pneumonia Severity - MDCalc

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Community Acquired Pneumonia - teachIM

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UPDATED 2025 Guidelines: Diagnosis and Management of Community-acquired Pneumonia. An Official American Thoracic Society Clinical Practice Guideline - PubMed

  • For adult outpatients with CAP who reach clinical stability, we suggest less than 5 days of antibiotics (minimum of 3-d duration) rather than 5 or more days of antibiotics

  • For adult inpatients with non-severe CAP who reach clinical stability, we suggest less than 5 days of antibiotics (minimum of 3-d duration) rather than 5 or more days of antibiotics

  • For adult inpatients with severe CAP who reach clinical stability, we suggest 5 or more days of antibiotics rather than less than 5 days of antibiotics

    • Criteria for Defining Severe Community-acquired Pneumonia

      • Validated definition includes either one major criterion or three or more minor criteria

      • Major criteria

        • Septic shock with need for vasopressors

        • Respiratory failure requiring mechanical ventilation

      • Minor criteria

        • Respiratory rate >30 breaths/min

        • PaO2 /FIO2 ratio <250

        • Multilobar infiltrates

        • Confusion/disorientation

        • Uremia (blood urea nitrogen concentration, >20 mg/dl)

        • Leukopenia (white blood cell count, <4,000 cells/μl)

        • Thrombocytopenia (platelet count, <100,000/μl)

        • Hypothermia (core temperature, <36C)

        • Hypotension requiring aggressive fluid resuscitation

Community-Acquired Pneumonia in Adults: Diagnosis and Management (aafp.org)

2019 Guidelines

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America | American Journal of Respiratory and Critical Care Medicine (atsjournals.org)

UPMC System P&T Committee Adult CAP Treatment Guidance

Things We Do for No Reason – Ordering Streptococcus pneumoniae Urinary Antigen in Patients with Community-Acquired Pneumonia

  • PUATs are common in the CAP diagnostic workup. However, the poor test characteristics and limited impact on antibiotic management renders them of low clinical utility.

References

Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581ST