title: [Community-acquired pneumonia].
abstract: Given the inherent difficulty of determining the cause of community-acquired pneumonia (CAP) (an etiological diagnosis is only established in 40-60 % of cases), assessment of severity plays a key role in stratifying CAP patients arriving at the emergency department in three groups according to the need for hospitalization: outpatient, hospitalization, and the need for intensive care unit (ICU) admission. The two most common severity scales used to assess the need for hospital admission in CAP are the Pneumonia Severity Index (PSI) and CURB-65 score while ATS-IDSA 2007 criteria are specific to evaluate the need for ICU admission. Because of the possible etiological differences between the three groups, distinct etiological tests and empiric antibiotic treatments will be required in each subgroup, although a possible pneumococcal etiology should always be considered, since Streptococcus pneumoniae is the most common etiology of CAP in all three groups. Clinical status must be reassessed 48 hours after empirical antibiotic treatment is started.
authors.affiliation: Unidad Cuidados Intensivos Respiratorios, Hospital Clínic Universitari, Valencia, España. blanquer_jos@gva.es
authors.forename: José
authors.initials: J
authors.lastname: Blanquer
authors.forename: Francisco
authors.initials: F
authors.lastname: Sanz
mesh_terms: D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D003422:Critical Care; D019468:Disease Management; D004352:Drug Resistance, Microbial; D004630:Emergencies; D006760:Hospitalization; D006801:Humans; D010102:Oxygen Inhalation Therapy; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents