“Pneumonia is an excellent example of an illness in which nursing measures (and not simply drug treatments) are very clearly central to a patient’s rapid and full recovery.”

In these pandemic times, a patient with signs and symptoms of pneumonia is assumed to have COVID-19. But of course other types of pneumonia continue to occur both in the hospital and in the community, and people with COVID-19 can develop secondary bacterial pneumonias as well.

Abandoning old pneumonia categories in determining antibiotic use.

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Until recently, pneumonia was routinely classified as either community-acquired or health care–associated, and the category determined treatment. Health care–associated pneumonias were more often caused by resistant organisms, while someone with no recent exposure to hospitals or nursing homes was thought likely to have a more “benign” infection. But now, a 2019 guideline developed jointly by the American Thoracic Society and the Infectious Diseases Society of America offers new recommendations for the initial treatment of pneumonia.

As described in a CE article “Community-Acquired Pneumonia:  A Review of Current Diagnostic Criteria and Management” in the December issue of AJN, the new guidelines recommend abandoning the use of categories of pneumonia to determine antibiotic coverage.

Instead, treatment decisions should be based on local epidemiology (what […]