The correct approach to community-acquired pneumonia in immunocompetent adults: review of current guidelines

Community-acquired pneumonia (CAP) often represents a clinical emergency requiring prompt and adequate antimicrobial treatment. The choice of antimicrobials, however, is difficult due to the variety of potential pathogens and to the spread of drug-resistance. Hence, a correct therapeutic approach should be based on the knowledge of the most frequently reported etiologies for the different clinical conditions, specific patient risk factors and the treatment setting (home, hospital, intensive or non intensive care unit) chosen accordingly The awareness of the local drug-resistance epidemiology and individual patient characteristics, such as age, history of antibiotic treatments and related adverse events, underlying diseases, concurrent therapies and expected adherence to treatment should also be considered. Lastly, an adequate CAP management should address other issues, including therapy duration, monitoring of its efficacy and adverse effects, and supportive measures. The guidelines for CAP management aim to provide the physician with the necessary knowledge and criteria to assist him in these crucial decisions, and their adoption result in a significant reduction of mortality, frequency and length of hospitalization, and costs. Herein, the authors review and discuss some of the main current guidelines for CAP management, highlighting their differences and similarities.