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JAMA Clinical Reviews

Diagnosis and Treatment of Community-Acquired Pneumonia (CAP)

Sep 16, 2024
Scott A. Flanders, MD, an expert on community-acquired pneumonia, and Valerie M. Vaughn, MD, MSc, discuss key insights into its diagnosis and treatment with Mary McGrae McDermott, MD. They explore the evolving definitions and classifications of CAP. Signs, symptoms, and the impact of the lung microbiome are emphasized. The conversation also covers emerging challenges in diagnosing mycoplasma and Legionella infections, antibiotic stewardship, and the importance of personalized therapy, especially in light of the COVID-19 pandemic.
22:55

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Quick takeaways

  • Community-acquired pneumonia now increasingly results from viral infections, necessitating a reevaluation of traditional diagnostic and treatment approaches.
  • Treatment strategies for pneumonia must consider disease severity and individual patient factors, promoting antimicrobial stewardship and personalized care.

Deep dives

Defining Community-Acquired Pneumonia

Community-acquired pneumonia is classified as any pneumonia that occurs outside of a hospital setting. This definition has evolved, eliminating the previous categorization of healthcare-associated pneumonia. Typical symptoms of this condition include fever, rapid heartbeat, shortness of breath, cough, and sputum production. Diagnosis is often challenging, as definitive identification of the causative agent occurs in less than half of cases, leading to an emphasis on empirical treatment based on clinical judgment.

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