Summary of Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Disease Society and the Canadian Thoracic Society.

Community-acquired pneumonia (CAP) is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in the knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity against Streptococcus pneumoniae has been important as well.It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Diseases Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.

[1]  Malbea A Lapete,et al.  Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices ( ACIP ) , 2004 .

[2]  L. Mandell,et al.  Summary of Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Disease Society and the Canadian Thoracic Society. , 2000, Canadian respiratory journal.

[3]  T. Marrie,et al.  A controlled trial of a critical pathway for treatment of community-acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin. , 2000, JAMA.

[4]  M. Niederman,et al.  Does appropriate antibiotic treatment influence outcome in community-acquired pneumonia (CAP)? , 2000 .

[5]  L. Kozak,et al.  National hospital discharge survey: annual summary, 1997. , 1999, Vital and health statistics. Series 13, Data from the National Health Survey.

[6]  Sheldon P Stone,et al.  Community-acquired pneumonia , 1998, The Lancet.

[7]  B. Naughton,et al.  Validation and Application of the Pneumonia Prognosis Index to Nursing Home Residents with Pneumonia , 1998, Journal of the American Geriatrics Society.

[8]  R. Muder Pneumonia in residents of long-term care facilities: epidemiology, etiology, management, and prevention. , 1998, The American journal of medicine.

[9]  M. Fine,et al.  Assessing prognosis and selecting an initial site of care for adults with community-acquired pneumonia. , 1998, Infectious disease clinics of North America.

[10]  I. Suramo,et al.  High-resolution computed tomography for the diagnosis of community-acquired pneumonia. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  A. Didier,et al.  Guidelines for management of adult community-acquired lower respiratory tract infections , 1998 .

[12]  M. R. Jacobs,et al.  Determination of Activities of Levofloxacin, Alone and Combined with Gentamicin, Ceftazidime, Cefpirome, and Meropenem, against 124 Strains of Pseudomonas aeruginosa by Checkerboard and Time-Kill Methodology , 1998, Antimicrobial Agents and Chemotherapy.

[13]  J. Bartlett,et al.  GUIDELINES FROM THE INFECTIOUS DISEASES SOCIETY OF AMERICA Community-Acquired Pneumonia in Adults: Guidelines for Management , 1998 .

[14]  ERS Task Force Report. Guidelines for management of adult community-acquired lower respiratory tract infections. European Respiratory Society. , 1998, European Respiratory Journal.

[15]  M. Fine,et al.  Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. , 1997, JAMA.

[16]  M. Kolczak,et al.  Incidence of Community-Acquired Pneumonia Requiring Hospitalization Results of a Population-Based Active Surveillance Study in Ohio , 1997 .

[17]  M. Fine,et al.  A prediction rule to identify low-risk patients with community-acquired pneumonia. , 1997, The New England journal of medicine.

[18]  M. Fine,et al.  The hospital discharge decision for patients with community-acquired pneumonia. Results from the Pneumonia Patient Outcomes Research Team cohort study. , 1997, Archives of internal medicine.

[19]  M. Fine,et al.  The hospital admission decision for patients with community-acquired pneumonia. Results from the pneumonia Patient Outcomes Research Team cohort study. , 1997, Archives of internal medicine.

[20]  A. Porath,et al.  The epidemiology of community-acquired pneumonia among hospitalized adults. , 1997, The Journal of infection.

[21]  J. P. Davis,et al.  Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). , 1997, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[22]  R. Peeling,et al.  Serological study of responses to selected pathogens causing respiratory tract infection in the institutionalized elderly. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[23]  R. Peeling,et al.  Ambulatory patients with community-acquired pneumonia: the frequency of atypical agents and clinical course. , 1996, The American journal of medicine.

[24]  J. Serra,et al.  Community-acquired pneumonia in chronic obstructive pulmonary disease: a Spanish multicenter study. , 1996, American journal of respiratory and critical care medicine.

[25]  R. H. Gates,et al.  Sputum gram's stain in community-acquired pneumococcal pneumonia. A meta-analysis. , 1996, The Western journal of medicine.

[26]  J. Bopp,et al.  Blood cultures in adult patients released from an urban emergency department: a 15-month experience. , 1996, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[27]  J. Bartlett Assessment of response to antimicrobial therapy and time to discharge in patients hospitalized with community-acquired pneumonia , 1996 .

[28]  J. Bartlett,et al.  Clinical pathways in an acute care setting: Community-acquired pneumonia , 1996 .

[29]  J. Ramirez,et al.  Diagnosis of Legionella pneumophila, Mycoplasma pneumoniae, or Chlamydia pneumoniae lower respiratory infection using the polymerase chain reaction on a single throat swab specimen. , 1996, Diagnostic microbiology and infectious disease.

[30]  J. Bartlett,et al.  Community‐Acquired Pneumonia: Impact of Immune Status , 1996, American journal of respiratory and critical care medicine.

[31]  M. Leinonen,et al.  The etiology of community-acquired pneumonia among hospitalized patients during a Chlamydia pneumoniae epidemic in Finland. , 1995, The Journal of infectious diseases.

[32]  R. van Furth,et al.  Aetiology of community-acquired pneumonia: a prospective study among adults requiring admission to hospital. , 1995, Thorax.

[33]  S. Chevret,et al.  Severe Community-acquired Pneumococcal Pneumonia , 1995 .

[34]  P. Mäkelä,et al.  Risk factors for pneumonia in the elderly. , 1994, The American journal of medicine.

[35]  Victor L. Yu,et al.  Medical Section pf the American Lung Association: Guidelines for the Initial Management of Adults with Community-acquired Pneumonia: Diagnosis, Assessment of Severity, and Initial Antimicrobial Therapy , 1993 .

[36]  T. Marrie,et al.  Serological investigation of pneumonia as it presents to the physician's office. , 1993, The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses.

[37]  R. Breiman,et al.  Pneumococcal polysaccharide vaccine efficacy. An evaluation of current recommendations. , 1993, JAMA.

[38]  S. L. Phillips,et al.  The Use of Intramuscular Cefoperazone versus Intramuscular Ceftriaxone in Patients with Nursing Home‐Acquired Pneumonia , 1993, Journal of the American Geriatrics Society.

[39]  S. Sahn Management of complicated parapneumonic effusions. , 1993, The American review of respiratory disease.

[40]  E. Jacobs Serological diagnosis of Mycoplasma pneumoniae infections: a critical review of current procedures. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[41]  J. Rello,et al.  A three-year study of severe community-acquired pneumonia with emphasis on outcome. , 1993, Chest.

[42]  L. Mandell,et al.  Antimicrobial treatment of community acquired pneumonia in adults: A conference report. , 1993, The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses.

[43]  Thebritishthoracicsocietyrese,et al.  The aetiology, management and outcome of severe community-acquired pneumonia on the intensive care unit. The British Thoracic Society Research Committee and The Public Health Laboratory Service. , 1992, Respiratory medicine.

[44]  J. Bates,et al.  Microbial etiology of acute pneumonia in hospitalized patients. , 1992, Chest.

[45]  R. Adair,et al.  The protective efficacy of polyvalent pneumococcal polysaccharide vaccine. , 1991, The New England journal of medicine.

[46]  T. Speroff,et al.  Comparison of physician judgment and decision aids for ordering chest radiographs for pneumonia in outpatients. , 1991, Annals of emergency medicine.

[47]  I. Williams,et al.  The value of routine microbial investigation in community-acquired pneumonia. , 1991, Respiratory medicine.

[48]  B. Andersson,et al.  Diagnosis of pneumonia by cultures, bacterial and viral antigen detection tests, and serology with special reference to antibodies against pneumococcal antigens. , 1991, The Journal of infectious diseases.

[49]  W. Kapoor,et al.  New and Emerging Etiologies for Community‐Acquired Pneumonia with Implications for Therapy: A Prospective Multicenter Study of 359 Cases , 1990, Medicine.

[50]  J. A. Cuello,et al.  Severe community-acquired pneumonia. Etiology, prognosis, and treatment. , 1990, The American review of respiratory disease.

[51]  A. Ortqvist,et al.  Diagnostic fiberoptic bronchoscopy and protected brush culture in patients with community-acquired pneumonia. , 1990, Chest.

[52]  D. Kaiser,et al.  Prediction of microbial aetiology at admission to hospital for pneumonia from the presenting clinical features. British Thoracic Society Pneumonia Research Subcommittee. , 1989, Thorax.

[53]  A. Chow,et al.  Cross-resistance of Pseudomonas aeruginosa to ciprofloxacin, extended-spectrum beta-lactams, and aminoglycosides and susceptibility to antibiotic combinations , 1989, Antimicrobial Agents and Chemotherapy.

[54]  T. Marrie,et al.  Community-acquired pneumonia requiring hospitalization: 5-year prospective study. , 1989, Reviews of infectious diseases.

[55]  W. F. Watkins Community acquired pneumonia: Importance of initial noninvasive bacteriologic and radiographic investigations , 1988 .

[56]  M. A. Spiteri,et al.  RELIABILITY OF ELICITING PHYSICAL SIGNS IN EXAMINATION OF THE CHEST , 1988, The Lancet.

[57]  T. Koepsell,et al.  Risk factors for acquiring pneumococcal infections. , 1986, Archives of internal medicine.

[58]  J. Bartlett,et al.  Bacteriology of hospital-acquired pneumonia. , 1986, Archives of internal medicine.

[59]  R. Dixon,et al.  Economic costs of respiratory tract infections in the United States. , 1985, The American journal of medicine.

[60]  D. Gremillion,et al.  Clinical value of paired sputum and transtracheal aspirates in the initial management of pneumonia. , 1985, Chest.

[61]  A. Ortqvist,et al.  Severe community-acquired pneumonia: factors influencing need of intensive care treatment and prognosis. , 1985, Scandinavian journal of infectious diseases.

[62]  B. Varkey,et al.  Empyema thoracis during a ten-year period. Analysis of 72 cases and comparison to a previous study (1952 to 1967). , 1981, Archives of internal medicine.

[63]  R. Light,et al.  Parapneumonic effusions. , 1980, The American journal of medicine.

[64]  R. Tuthill,et al.  Differences in etiology of pneumonias in nursing home and community patients. , 1978, JAMA.

[65]  D. E. Potts,et al.  The incidence and clinical correlates of parapneumonic effusions in pneumococcal pneumonia. , 1978, Chest.

[66]  E. Barrett-Connor The nonvalue of sputum culture in the diagnosis of pneumococcal pneumonia. , 2015, The American review of respiratory disease.