Update in adult community-acquired pneumonia: key points from the new American Thoracic Society/Infectious Diseases Society of America 2019 guideline.

ABSTRACT

PURPOSE OF REVIEW The American Thoracic Society and Infectious Diseases Society of America recently released their joint guideline for the diagnosis and treatment of adults with community-acquired pneumonia (CAP). The co-chairs of the guideline committee provide a summary of the guideline process, key recommendations from the new guideline and future directions for CAP research. RECENT FINDINGS: The guideline committee included 14 experts from the two societies. Sixteen questions for the guideline were selected using the PICO format. The GRADE approach was utilized to review the available evidence and generate recommendations. The recommendations included expanded microbiological testing for patients suspected of drug-resistant infections, empiric first-line therapy recommendations for outpatients and inpatients including use of beta-lactam monotherapy for uncomplicated outpatients, elimination of healthcare-associated pneumonia as a treatment category, and not recommending corticosteroids as routine adjunct therapy. SUMMARY: CAP is a major cause of morbidity and mortality. Effective antibiotic therapy is available and remains largely empirical. New diagnostic tests and treatment options are emerging and will lead to guideline updates in the future.