JOURNAL ARTICLE
REVIEW

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

Julio A Ramirez, Daniel M Musher, Scott E Evans, Charles Dela Cruz, Kristina A Crothers, Chadi A Hage, Stefano Aliberti, Antonio Anzueto, Francisco Arancibia, Forest Arnold, Elie Azoulay, Francesco Blasi, Jose Bordon, Steven Burdette, Bin Cao, Rodrigo Cavallazzi, James Chalmers, Patrick Charles, Jean Chastre, Yann-Erick Claessens, Nathan Dean, Xavier Duval, Muriel Fartoukh, Charles Feldman, Thomas File, Filipe Froes, Stephen Furmanek, Martin Gnoni, Gustavo Lopardo, Carlos Luna, Takaya Maruyama, Rosario Menendez, Mark Metersky, Donna Mildvan, Eric Mortensen, Michael S Niederman, Mathias Pletz, Jordi Rello, Marcos I Restrepo, Yuichiro Shindo, Antoni Torres, Grant Waterer, Brandon Webb, Tobias Welte, Martin Witzenrath, Richard Wunderink
Chest 2020 June 16
32561442

BACKGROUND: Community-acquired pneumonia (CAP) guidelines have improved the management and outcomes of patients with CAP, primarily by standardization of initial empiric therapy. But current society-published guidelines exclude immunocompromised patients.

RESEARCH QUESTION: There is no concensus regarding the initial management 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 management 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, microbiological work-up, general principles of empiric therapy, and empiric therapy for specific pathogens.

INTERPRETATION: This document offer general suggestions for the initial management of the immunocompromised patient who arrives at the hospital with pneumonia.

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