title: SWAB/NVALT (Dutch Working Party on Antibiotic Policy and Dutch Association of Chest Physicians) guidelines on the management of community-acquired pneumonia in adults.
abstract: The Dutch Working Party on Antibiotic Policy (SWAB) and the Dutch Association of Chest Physicians (NVALT) convened a joint committee to develop evidence-based guidelines on the diagnosis and treatment of community acquired pneumonia (CAP). The guidelines are intended for adult patients with CAP who present at the hospital and are treated as outpatients as well as for hospitalised patients up to 72 hours after admission. Areas covered include current patterns of epidemiology and antibiotic resistance of causative agents of CAP in the Netherlands, the possibility to predict the causative agent of CAP on the basis of clinical data at first presentation, risk factors associated with specific pathogens, the importance of the severity of disease upon presentation for choice of initial treatment, the role of rapid diagnostic tests in treatment decisions, the optimal initial empiric treatment and treatment when a specific pathogen has been identified, the timeframe in which the first dose of antibiotics should be given, optimal duration of antibiotic treatment and antibiotic switch from the intravenous to the oral route. Additional recommendations are made on the role of radiological investigations in the diagnostic work-up of patients with a clinical suspicion of CAP, on the potential benefit of adjunctive immunotherapy, and on the policy for patients with parapneumonic effusions.
authors.affiliation: Department of Internal Medicine, University of Amsterdam, Amsterdam, the Netherlands. w.j.wiersinga@amc.uva.nl
authors.forename: W J
authors.initials: WJ
authors.lastname: Wiersinga
authors.forename: M J
authors.initials: MJ
authors.lastname: Bonten
authors.forename: W G
authors.initials: WG
authors.lastname: Boersma
authors.forename: R E
authors.initials: RE
authors.lastname: Jonkers
authors.forename: R M
authors.initials: RM
authors.lastname: Aleva
authors.forename: B J
authors.initials: BJ
authors.lastname: Kullberg
authors.forename: J A
authors.initials: JA
authors.lastname: Schouten
authors.forename: J E
authors.initials: JE
authors.lastname: Degener
authors.forename: R
authors.initials: R
authors.lastname: Janknegt
authors.forename: T J
authors.initials: TJ
authors.lastname: Verheij
authors.forename: A P E
authors.initials: AP
authors.lastname: Sachs
authors.forename: J M
authors.initials: JM
authors.lastname: Prins
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000473:pathology; D019468:Disease Management; D004333:Drug Administration Routes; D024881:Drug Resistance, Bacterial; D006801:Humans; D009426:Netherlands; D011014:Pneumonia / Q000188:drug therapy* / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents