Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America.
Open accessAbstract
Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia. Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. Results: The panel addressed 16 specific areas for recommendations spanning questions of diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions. Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Early administration of appropriate antimicrobials is one of the most effective interventions to reduce mortality in patients with sepsis.
“Early administration of appropriate antimicrobials is one of the most effective interventions to reduce mortality in patients with sepsis (96-98).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [98]
The Question 9 evidence summary reports lower mortality with certain antibiotic regimens in patients with community-acquired pneumonia. It does not establish that early administration of appropriate antimicrobials reduces mortality in patients with sepsis generally, or that it is among the most effective interventions; the Question 11 discussion of sepsis concerns antibiotic de-escalation instead. No page number was provided in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe mortality reduction associated with early antimicrobials appears strongest in patients with septic shock, where studies have reported a strong association between time to antibiotics and death in patients with septic shock but weaker associations in patients without septic shock.
“The mortality reduction associated with early antimicrobials appears strongest in patients with septic shock, where studies have reported a strong association between time to antibiotics and death in patients with septic shock but weaker associations in patients without septic shock (98,109,110).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [98]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn patients with sepsis without shock, the association between time to antimicrobials and mortality within the first few hours from presentation is less consistent.
“In patients with sepsis without shock, the association between time to antimicrobials and mortality within the first few hours from presentation is less consistent (98, 110).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [98]
The guideline’s Recommendations, Question 15 (page unavailable), discuss antibiotic treatment duration and clinical stability in community-acquired pneumonia, not the association between time to first antimicrobials and mortality. Searches for sepsis without shock, early-hours treatment timing, and mortality found no passage addressing the claimed association. (LLM, conf=0.72)
Experimental — accuracy not yet measuredObservational studies suggest that mortality may increase after intervals exceeding 3-5 hours from hospital arrival and/or sepsis recognition.
“Observational studies do, however, suggest that mortality may increase after intervals exceeding 3-5 hours from hospital arrival and/or sepsis recognition (98,111,119,120).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [98]
The guideline’s Question 15 discusses five days as a duration of antibiotic treatment and associates failure to achieve clinical stability within five days with higher mortality. Neither that section nor the other retrieved passages addresses mortality after a 3–5-hour interval from hospital arrival or sepsis recognition. Searches for those intervals and for delayed antibiotic initiation did not locate the claimed finding in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredPublished guidelines for community-acquired pneumonia recommend initiation of antimicrobials regardless of procalcitonin level.
“Published guidelines for the management of community-acquired pneumonia recommend initiation of antimicrobials for patients with community-acquired pneumonia regardless of procalcitonin level [132].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [132]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 222 · Cited by 3,657
- Authors
- Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., Cooley, L. A., Dean, N. C., Fine, M. J., Flanders, S. A., Griffin, M. R., Metersky, M. L., Musher, D. M., Restrepo, M. I., & Whitney, C. G.
- Affiliations
- Centers for Disease Control and Prevention (US)
- ORCID
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-10-01
- Volume
- 200
- Issue
- 7
- Pages
- e45-e67
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- PMC
- PMC6812437
- OpenAlex
- W2977322360
- Cited by
- 3,657
- References
- 222
- Citations by year
- 2026: 480 · 2025: 540 · 2024: 490 · 2023: 492 · 2022: 502 · 2021: 590 · 2020: 535 · 2019: 22 · 2017: 1 · 2016: 1
- FWCI
- 314.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- UWA Profiles and Research Repository (UWA) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Funders
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Massachusetts General Hospital
- Gilead Sciences
- Infectious Diseases Society of America
- Vanderbilt University
- University of Connecticut
- University of Washington
- University of Pittsburgh
- Sunovion
- McMaster University
- Savara Pharmaceuticals
- Insmed
- Shionogi
- Vlaamse regering
- Grifols
- National Institutes of Health (UL1TR001863)
- Centers for Disease Control and Prevention
- National Heart, Lung, and Blood Institute (K23HL128793)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Keywords
- community-acquired pneumonia, adults, empirical antibiotic therapy, diagnostic testing, place of care, pneumonia management
- MeSH terms
- Blood Culture, Adult, Ambulatory Care, Anti-Bacterial Agents, Antigens, Bacterial, Drug Therapy, Combination, Haemophilus Infections, Hospitalization, Humans, Legionellosis, Pneumonia, Pneumococcal, Pneumonia, Mycoplasma, Pneumonia, Staphylococcal, Severity of Illness Index, Sputum, Radiography, Thoracic, United States, Community-Acquired Infections, Pneumonia, Bacterial, Macrolides, Chlamydophila Infections, Moraxellaceae Infections, Culture Techniques, beta-Lactams
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
