title: Lower respiratory tract infections and community acquired pneumonia in adults.
abstract: BACKGROUND
  Lower respiratory tract infections--acute bronchitis and community acquired pneumonia (CAP)--are important causes of morbidity in Australia. Acute bronchitis is often treated with antibiotics, although the cause is usually viral. Community acquired pneumonia may be fatal, particularly in the elderly, therefore appropriate assessment and management is essential.
  
  
  OBJECTIVE
  This article describes the aetiology, clinical assessment, investigations and management of acute bronchitis and CAP in the community.
  
  
  CONCLUSIONS
  Clinical assessment is important for acute bronchitis and CAP, with investigations such as C reactive protein, serology, and chest X-ray informing diagnosis and management of the latter. Causative organisms are usually not identified, but are presumed to be viral for acute bronchitis, and Streptococcus pneumoniae for CAP; although 'atypicals' are also important. Antibiotics should generally not be prescribed for acute bronchitis, however, there is some evidence they may provide limited benefits in patients who have chest signs, are very unwell, are older, have comorbidities, or smoke. In patients with CAP, treated outside of hospital, the combination of amoxycillin and doxycycline/roxithromycin is the treatment of choice.
authors.affiliation: Department of General Practice, University of Adelaide, South Australia. nigel.stocks@adelaide.edu.au
authors.forename: Nigel
authors.initials: N
authors.lastname: Stocks
authors.forename: John
authors.initials: J
authors.lastname: Turnidge
authors.forename: Alan
authors.initials: A
authors.lastname: Crockett
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001991:Bronchitis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D002689:Chlamydia / Q000302:isolation & purification; D017714:Community-Acquired Infections / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D003937:Diagnosis, Differential; D005194:Family Practice / Q000379:methods*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007875:Legionella / Q000302:isolation & purification; D008297:Male; D009174:Mycoplasma / Q000302:isolation & purification; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy*; D013902:Radiography, Thoracic; D012135:Respiratory Sounds / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents