title: Community-acquired pneumonia.
abstract: OBJECTIVE
  This review examines the epidemiology, diagnosis, prognosis, treatment and prevention of community-acquired pneumonia (CAP) in adults.
  
  
  RESULTS
  CAP is a significant cause of morbidity and mortality. Streptococcus pneumoniae is the most common CAP pathogen; however, microbial cause varies by geographic location and host factors. Identification of a microbial cause in CAP remains challenging - 30-65% of cases do not have a pathogen isolated. The use of molecular techniques in addition to culture, serology and urinary antigen testing has improved diagnostic yield. Scoring systems are useful for CAP prognostication and site of care decisions. Studies evaluating novel biomarkers including pro-B-type natriuretic peptide and procalcitonin suggest potential adjunctive roles in CAP prognosis. Guideline-based treatment for CAP has changed little in recent years. Effective and timely antimicrobial therapy is crucial in optimizing outcomes and should be based on local antimicrobial susceptibility patterns. Macrolides may have additional anti-inflammatory properties and a mortality benefit in severe CAP. Preventive strategies include immunization and modification of specific patient risk factors.
  
  
  CONCLUSIONS
  CAP is common and causes considerable morbidity and mortality. A comprehensive approach including advanced diagnostic testing, effective and timely antimicrobial therapy and prevention is required to optimize CAP outcomes.
authors.affiliation: aDivision of Infectious Diseases bAssociate Clinical Professor, Divisions of Critical Care Medicine and Infectious Diseases, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Leah T
authors.initials: LT
authors.lastname: Remington
authors.forename: Wendy I
authors.initials: WI
authors.lastname: Sligl
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D014943:Global Health; D006801:Humans; D007114:Immunization; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis* / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012307:Risk Factors; D016540:Smoking Cessation; D022541:Streptococcal Vaccines / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D022541:Streptococcal Vaccines