Primary care summary of the British Thoracic Society Guidelines for the management of community acquired pneumonia in adults: 2009 update. Endorsed by the Royal College of General Practitioners and the Primary Care Respiratory Society UK.
BACKGROUND
The identification and management of adults presenting with pneumonia is a major challenge for primary care health professionals. This paper summarises the key recommendations of the British Thoracic Society (BTS) Guidelines for the management of Community Acquired Pneumonia (CAP) in adults.


METHODS
Systematic electronic database searches were conducted in order to identify potentially relevant studies that might inform guideline recommendations. Generic study appraisal checklists and an evidence grading from A+ to D were used to indicate the strength of the evidence upon which recommendations were made.


CONCLUSIONS
This paper provides definitions, key messages, and recommendations for handling the uncertainty surrounding the clinical diagnosis, assessing severity, management, and follow-up of patients with CAP in the community setting. Diagnosis and decision on hospital referral in primary care is based on clinical judgement and the CRB-65 score. Unlike some other respiratory infections (e.g. acute bronchitis) an antibiotic is always indicated when a clinical diagnosis of pneumonia is made. Timing of initial review will be determined by disease severity. When there is a delay in symptom or radiographic resolution beyond six weeks, the main concern is whether the CAP was a complication of an underlying condition such as lung cancer.
Allergy & Respiratory Research Group, Division of Community Health Sciences:GP Section, University of Edinburgh, Scotland, UK.
Mark L
ML
Levy
Ivan
I
Le Jeune
Mark A
MA
Woodhead
John T
JT
Macfarlaned
Wei Shen
WS
Lim
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D010353:Patient Education as Topic; D010821:Physicians, Family; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D011320:Primary Health Care; D012307:Risk Factors; D012720:Severity of Illness Index; D012955:Societies, Medical; D006113:United Kingdom
D000900:Anti-Bacterial Agents