Treatment of Community-Acquired Pneumonia in Immunocompromised Adults: A Consensus Statement Regarding Initial Strategies

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    Author
    Ramirez, JA; Musher, DM; Evans, SE; Dela Cruz, C; Crothers, KA; Hage, CA; Aliberti, S; Anzueto, A; Arancibia, F; Arnold, F; ...
    Date
    2020-11-01
    Source Title
    Chest
    Publisher
    ELSEVIER
    University of Melbourne Author/s
    Charles, Patrick
    Affiliation
    Medicine and Radiology
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    Document Type
    Journal Article
    Citations
    Ramirez, J. A., Musher, D. M., Evans, S. E., Dela Cruz, C., Crothers, K. A., Hage, C. A., Aliberti, S., Anzueto, A., Arancibia, F., Arnold, F., Azoulay, E., Blasi, F., Bordon, J., Burdette, S., Cao, B., Cavallazzi, R., Chalmers, J., Charles, P., Chastre, J. ,... Wunderink, R. (2020). Treatment of Community-Acquired Pneumonia in Immunocompromised Adults: A Consensus Statement Regarding Initial Strategies. CHEST, 158 (5), pp.1896-1911. https://doi.org/10.1016/j.chest.2020.05.598.
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    URI
    http://hdl.handle.net/11343/254490
    DOI
    10.1016/j.chest.2020.05.598
    Open Access URL
    Published version
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297164
    Abstract
    BACKGROUND: Community-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients. RESEARCH QUESTION: There is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP. STUDY DESIGN AND METHODS: This consensus document was created by a multidisciplinary panel of 45 physicians with experience in the treatment of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus. RESULTS: The panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiologic workup, general principles of empirical therapy, and empirical therapy for specific pathogens. INTERPRETATION: This document offers general suggestions for the initial treatment of the immunocompromised patient who arrives at the hospital with pneumonia.

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