Diagnosis and Treatment of Adults with Community-Acquired Pneumonia: IDSA/ATS Consensus Guidelines

The 2019 IDSA/ATS CAP guideline updated the 2007 guideline with new evidence on severity assessment, biomarkers, and antibiotic selection.

Evidence-based guideline using GRADE methodology.

Key recommendations: (1) PSI preferred over CURB-65 for severity; (2) Outpatient: amoxicillin or doxycycline (no comorbidities); (3) Inpatient non-severe: beta-lactam + macrolide or respiratory fluoroquinolone; (4) Severe CAP (ICU): beta-lactam + macrolide or beta-lactam + respiratory FQ; (5) Procalcitonin NOT recommended to guide antibiotic initiation; (6) Routine atypical coverage for outpatient CAP.

Know PSI vs CURB-65, the definition of severe CAP (major/minor criteria), and antibiotic selection by severity. Severe CAP = ICU admission or ≥3 minor criteria. Dual coverage (beta-lactam + macrolide) for severe CAP is standard.

Guideline — some recommendations based on low-quality evidence. Antibiotic resistance patterns vary by region.