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Managing Community-Acquired Pneumonia in Adults

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Community-acquired pneumonia (CAP), also known as community-acquired bacterial pneumonia (CABP), is an infection of the lungs that is acquired outside of the hospital setting. Lower respiratory infections including CAP are the leading cause of death from infectious disease in the world. In the US, there were 1.3 million emergency department visits and 49,157 deaths attributed to pneumonia in 2017. When combined with influenza, pneumonia was the eighth leading cause of death in the US. In the elderly, CAP has a higher burden of hospitalization and total cost than heart attack, stroke, and fractures combined. It is linked to 1.5 million hospitalizations in adults each year, with an estimated mortality rate of 6.5% during hospitalization.

In October of 2019, the American Thoracic Society, along with the Infectious Diseases Society of America, published an updated guideline on the diagnosis and treatment of adults with CAP. This guideline is the long-awaited update to the 2007 version published by the same groups. This update does not provide recommendations for managing foreign travelers or patients who are immunocompromised (eg, patients receiving cancer chemotherapy, bone marrow transplant recipients, HIV patients, etc). Notable changes to the guideline include the removal of the healthcare-associated pneumonia category, the use of empiric amoxicillin monotherapy for outpatients with no coexisting conditions (eg, chronic, lung, heart, liver, or kidney disease; diabetes, asplenia, malignancy, or alcoholism), and the use of macrolide monotherapy only if local resistance rates are less than 25%. This issue summarizes the causes, risk factors, and current treatment recommendations for CAP in adults. The 2019 guideline was released before the pandemic caused by severe acute respiratory syndrome coronavirus(SARS CoV-2). The guideline and this issue do not include information on managing CAP in patients with coronavirus disease 2019 (COVID-19).


Publication Date: 09/22/2020
Expiration Date: 09/22/2023
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Ann Lloyd, PharmD, BCPS-AQ ID, BCIDP is a Clinical Associate Professor in the Department of Pharmacy: Clinical and Administrative Sciences at the University of Oklahoma College of Pharmacy. She is also a Clinical Pharmacy Specialist in Infectious Diseases and PYG2 Infectious Diseases Pharmacy Residency Program Director at Saint Francis Hospital in Tulsa,Oklahoma.

Disclosure Statement

Dr. Lloyd reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Target Audience

This accredited program is targeted to pharmacists .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe the most common pathogens implicated in CAP, along with risk factors for resistant organisms.
    2. Discuss the treatment options for CAP, taking into consideration coexisting conditions and severity of illness.
    3. Counsel patients on potential side effects of the antibiotics recommended for treatment and strategies for the prevention of CAP.

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The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-20-009-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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