What are the IDSA and ATS guidelines on the classification of bacterial pneumonia?

Updated: Sep 30, 2020
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

The concept of HCAP (including NHAP) has been called into question in the 2016 Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) guidelines. [12] Based on a 2014 meta-analysis of 24 studies, it was found that the concept of HCAP is predominantly based on low-quality evidence confounded by publication bias and does not accurately identify multidrug-resistant organisms. After adjusting for age and comorbidities, patients within this category did not have an increased risk of mortality. [13] Based on this meta-analysis, the 2016 IDSA and ATS guidelines have called for the removal of the concept of HCAP, [12] encouraging patients previously grouped under this category to be treated as if they have CAP, with guidance of hospital-specific antibiograms and local resistance patterns.


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