acep mobile

Pneumonia (Community-Acquired - Adult)

Management of Adult Patients Presenting to the Emergency Department with Community-Acquired Pneumonia (November 2009)

Complete Clinical Policy on Community-Acquired Pneumonia (PDF)

 

Scope of Application. This guideline is intended for physicians working in hospital-based emergency departments.

Inclusion Criteria. This guideline is intended for patients 18 years of age or older with signs and symptoms of CAP and radiographic evidence of pneumonia.

Exclusion Criteria. This guideline is not intended for patients who are pregnant, or immunocompromised (including patients with HIV/AIDS, organ transplant, or recipients of corticosteroids, antineoplastic therapy, or other immunosuppressive agents), or have been hospitalized within the last 30 days.

Critical Questions

1. Are routine blood cultures indicated in patients admitted with CAP?

  • Level A recommendations. None specified.


  • Level B recommendations. Do not routinely obtain blood cultures in patients admitted with CAP.


  • Level C recommendations. Consider obtaining blood cultures in higher-risk patients admitted with CAP (eg, severe disease, immunocompromise, significant comorbidities, or other risk factors for infection with resistant organisms).

 

2. In adult patients with CAP without severe sepsis, is there a benefit in mortality or morbidity from the administration of antibiotics within a specific time course?

  • Level A recommendations. None specified.


  • Level B recommendations. There is insufficient evidence to establish a benefit in mortality or morbidity from antibiotics administered in less than 4, 6, or 8 hours from ED arrival.


  • Level C recommendations. Administer antibiotics as soon as feasible once the diagnosis of CAP is established; there is insufficient evidence to establish a benefit in morbidity or mortality from antibiotics administered within any specific time course.

 

Purpose of ACEP’s Clinical Policies

Clinical Findings and Strength of Recommendations