Severe community-acquired pneumonia

Severe community-acquired pneumonia continues to represent a serious challenge to the clinician, as indicated by mortality rates ranging from 21% to 54%. In the last decade, important progress has been made in the clinical definition, description of epidemiology, and identification of prognostic factors of this entity. Pivotal to all efforts to improve the prognosis is an appropriate initial antimicrobial treatment. In this article, an epidemiologic (empiric) initial approach that may be modified by results of microbial investigation in the individual case is advocated.