Clinical Microbiology and Antimicrobial Chemotherapy. 2008; 10(4):305-321
Community-acquired pneumonia (CAP) is the 4-8th leading killer of people worldwide and the most leading cause of death from infections in US. This article is a review of innovations and differences between the recent American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) guidelines for the management of patients with CAP, which are based on assessment of disease severity. According to IDSA guidelines, decisions on antimicrobial therapy are guided by place of treatment (outpatient settings, general ward or intensive care unit). According to ATS guidelines, all patients with CAP should be divided into 4 groups based on presence of underlying cardiovascular and lung diseases, other risk factors for multi-drug resistant pathogens (resistant Streptococcus pneumoniae, Enterobacteriaceae and Pseudomonas aeruginosa) as well as place of treatment. Both guidelines suggest using PORT score as a tool to determine appropriate place of treatment. However, the most recent IDSA/ATS consensus guidelines recommend assessment using more available CURB/CRB-65 scores, which should be repeated within the first few hours of observation.