Acquired characteristics

@article{doi102105ajph156549a,
    author = "Kofoid, Charles A.",
    title = "The Inheritance of Acquired Characteristics",
    year = "1925",
    journal = "American journal of public health",
    url = "https://doi.org/10.2105/ajph.15.6.549-a",
    doi = "10.2105/ajph.15.6.549-a",
    openalex = "W2034706608"
}

@article{zirkel1946the1,
    author = "Zirkel, C",
    title = "The early history of the idea of acquired characters and of pangenesis",
    year = "1946",
    journal = "Transactions of the American Philosophical Society, v. 35, p. 91-151",
    note = "talkorigins\_source = {true}; raw\_reference = {Zirkel, C., 1946, The early history of the idea of acquired characters and of pangenesis: Transactions of the American Philosophical Society, v. 35, p. 91-151.}"
}

Article1 May 1964Pneumococcal Bacteremia with Especial Reference to Bacteremic Pneumococcal PneumoniaROBERT AUSTRIAN, M.D., JEROME GOLD, M.D.ROBERT AUSTRIAN, M.D., JEROME GOLD, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-5-759 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTwenty-five years have elapsed since the subject of pneumococcal bacteremia has been reviewed (1, 2). In that period many changes have taken place both in the treatment of this disorder and in the attitude of the medical profession toward it. The introduction of a series of antimicrobial drugs effective against all capsular types of pneumococcus has led to widespread abandonment of the more precise bacteriologic techniques designed for the recognition of this organism and secondarily to the impression that pneumococcal disease no longer constitutes a serious medical problem. To determine the validity of these practices and attitudes, established techniques for...References1. TILGHMANFINLAND RCM: Clinical significance of bacteremia in pneumococcal pneumonia. Arch. Intern. Med. (Chicago) 59: 602, 1937. CrossrefGoogle Scholar2. BULLOWA JG: The Management of the Pneumonias, Oxford University Press, New York, 1937. Google Scholar3. MACLEODAUSTRIANFINLAND CMRM: Pneumococcus, in Diagnostic Procedures and Reagents, American Public Health Association, New York, 1963, pp. 222-30. Google Scholar4. Statistical Abstract of the United States, 1958, 79th Annual Edition: U. S. Department of Commerce, Bureau of the Census, U. S. Government Printing Office, Washington, D. C., 1958, p. 6. Google Scholar5. DINGLEBADGERFELLERHODGESJORDANRAMMELKAMP JHGFAERGWSCH: A study of illness in a group of Cleveland families. I. Plan of study and certain general observations. Amer. J. Hyg. 58: 16, 1953. MedlineGoogle Scholar6. REIMANN HA: Current problems of the pneumonias. Ann. Intern. Med. 56: 144, 1962. LinkGoogle Scholar7. Advance Report, Vital Statistics of the United States, 1961. Final Natality and Mortality Statistics: National Vital Statistics Division, Department of Health, Education, and Welfare, United States Public Health Service, Nov., 1962. Google Scholar8. WOODSMITH WBMR: The inhibition of surface phagocytosis by the capsular "slime layer" of pneumococcus Type III. J. Exp. Med. 90: 85, 1949. CrossrefMedlineGoogle Scholar9. WOODSMITH WBMR: Host-parasite relationships in experimental pneumonia due to pneumococcus Type III. J. Exp. Med. 92: 85, 1950. CrossrefMedlineGoogle Scholar10. BALCH HH: Relation of nutritional deficiency in man to antibody production. J. Immun. 64: 397, 1950. MedlineGoogle Scholar11. BALCHSPENCER HHMT: Phagocytosis by human leukocytes. II. Relation of nutritional deficiency in man to phagocytosis. J. Clin. Invest. 33: 1321, 1954. CrossrefMedlineGoogle Scholar12. JETERMCKEEMASON WSAPRJ: Inhibition of immune phagocytosis of Diplococcus pneumoniae by human neutrophiles with antibody against complement. J. Immun. 86: 386, 1961. MedlineGoogle Scholar13. DOWLINGLEPPER HFMH: The effect of antibiotics (Penicillin, Aureomycin, and Terramycin) on the fatality rate and incidence of complications in pneumococcic pneumonia. Amer. J. Med. Sci. 222: 396, 1951. CrossrefMedlineGoogle Scholar14. MACLEODHODGESHEIDELBERGERBERNHARD CMRGMWG: Prevention of pneumococcal pneumonia by immunization with specific capsular polysaccharides. J. Exp. Med. 82: 445, 1945. CrossrefGoogle Scholar15. KAUFMAN P: Pneumonia in old age. Arch. Intern. Med. (Chicago) 79: 518, 1947. CrossrefGoogle Scholar16. HEIDELBERGER M: Persistence of antibodies in man after immunization, in The Nature and Significance of the Antibody Response, edited by PAPPENHEIMER, A. M., JR., Columbia University Press, New York, 1953, pp. 90-101. Google Scholar17. HEIDELBERGERMACLEODDI LAPI MCMM: The human antibody response to simultaneous injection of six specific polysaccharides of pneumococcus. J. Exp. Med. 88: 369, 1948. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, PennsylvaniaFrom the Department of Medicine, State University of New York Downstate Medical Center, the Medical Service of Kings County Hospital, Brooklyn, New York, and the Department of Research Medicine, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.These data were presented in part at the 76th Session of the Association of American Physicians, April 30, 1963.Requests for reprints should be addressed to Robert Austrian, M.D., Hospital of the University of Pennsylvania, Philadelphia 4, Pennsylvania. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEffects of Aging and Associated Conditions on Humoral Responses to Respiratory Tract InfectionsClinical Features and Outcomes of Streptococcus pneumoniae Meningitis in Children: A Retrospective Analysis of 26 Cases in ChinaBioassay- and QSAR-based screening of toxic transformation products and their formation under chlorination treatment on levofloxacinComparing scoring systems for prediction of mortality in patients with bloodstream infectionCardiovascular complications of Streptococcus pneumoniae bacteraemiaLower Density and Shorter Duration of Nasopharyngeal Carriage by Pneumococcal Serotype 1 (ST217) May Explain Its Increased Invasiveness over Other SerotypesGastrointestinal symptoms in invasive pneumococcal disease: a cohort studyEffectiveness of Streptococcus Pneumoniae Urinary Antigen Testing in Decreasing Mortality of COVID-19 Co-Infected Patients: A Clinical InvestigationB Cell ImmunosenescenceFormulation technologies and advances for oral delivery of novel nitroimidazoles and antimicrobial peptidesPneumococcal Vaccines for Adults: What's Next?Pneumococcal VaccinesNext-Generation Whole-Cell Pneumococcal VaccinePneumococcal VaccinesInfluence of Obesity on Pneumococcus Infection Risk in the ElderlyPneumococcal Community-Acquired Pneumonia Detected by Serotype-Specific Urinary Antigen Detection AssaysEarly administration of appropriate antimicrobial agents to improve the outcome of carbapenem-resistant Acinetobacter baumannii complex bacteraemic pneumoniaA Short History of VaccinationPneumococcal Polysaccharide VaccinesA Perfect Storm: Increased Colonization and Failure of Vaccination Leads to Severe Secondary Bacterial Infection in Influenza Virus-Infected Obese MiceStreptococcus pneumoniae antimicrobial resistance decreased in the Helsinki Metropolitan Area after routine 10-valent pneumococcal conjugate vaccination of infants in FinlandTime to antibiotics administration and outcome in community-acquired pneumonia: Secondary analysis of a randomized controlled trialCombination therapy with ampicillin and azithromycin improved outcomes in a mouse model of group B streptococcal sepsisTyk2 as a target for immune regulation in human viral/bacterial pneumoniaConcurrent Infection with Hepatitis C Virus and Streptococcus pneumoniaeComparative evaluation of a newly developed 13-valent pneumococcal conjugate vaccine in a mouse modelWhite Blood Cell Counts, Alcoholism, and Cirrhosis in Pneumococcal PneumoniaResistance in Streptococcus pneumoniaeInvasive Pneumococcal Disease: Still Lots to Learn and a Need for Standardized Data Collection InstrumentsA 32-Year Study of the Effect of Pneumococcal Vaccines on Invasive Streptococcus pneumoniae DiseaseDectin-2-dependent host defense in mice infected with serotype 3 Streptococcus pneumoniaeDetermination of neutrophil CD64 expression as a prognostic biomarker in patients with community-acquired pneumoniaAntimicrobial stewardship in South Africa: a fruitful endeavourPredictive and prognostic factors in patients with blood-culture-positive community-acquired pneumococcal pneumoniaPredictors and Implications of Early Clinical Stability in Patients Hospitalized for Moderately Severe Community-Acquired PneumoniaPneumococcal Vaccination Strategies. An Update and PerspectiveThe impact of global budgeting on health service utilization, health care expenditures, and quality of care among patients with pneumonia in TaiwanAdjunctive Corticotherapy for Community Acquired Pneumonia: A Systematic Review and Meta-AnalysisMacrophage Migration Inhibitory Factor Is Detrimental in Pneumococcal Pneumonia and a Target for Therapeutic ImmunomodulationBlood culture fluorescence rates predict severity and mortality of invasive pneumococcal pneumoniaThe problem of early mortality in pneumococcal pneumonia: a study of risk factorsGlucocorticoid-Augmented Efferocytosis Inhibits Pulmonary Pneumococcal Clearance in Mice by Reducing Alveolar Macrophage Bactericidal FunctionAntibiotic resistancePneumonie – "The old man's friend"Antiinfektive Erstherapie bei SepsisAcute PneumoniaStreptococcus pneumoniaePrevention of Streptococcus pneumoniae (pneumococcal) infections in adultsAntiinfektive Erstherapie bei SepsisReasons for adult immunization – Prevention of most frequent respiratory infectionsPneumococcal Vaccine and Patients with Pulmonary DiseasesA Leukocyte Score to Improve Clinical Outcome Predictions in Bacteremic Pneumococcal Pneumonia in AdultsPneumococcal colonisation density: a new marker for disease severity in HIV-infected adults with pneumoniaVaccination anti-pneumococcique chez l'adulte: comment améliorer la couverture vaccinale?Differences in serious clinical outcomes of infection caused by specific pneumococcal serotypes among adultsAdjunctive Corticosteroid Therapy Improves Lung Immunopathology and Survival During Severe Secondary Pneumococcal Pneumonia in MiceThe Pneumococcus: Population Biology and VirulenceThe History of Pneumococcal DiseaseHistory of Pneumococcal ImmunizationPneumococcal Pneumonia in Adults: Epidemiology, Clinical Features, Diagnosis, and TherapyPneumococcal VaccinesAttachment and Invasion of the Respiratory TractImmunodeficiency and Invasive Pneumococcal DiseaseClinical Relevance of Antibiotic Resistance in Pneumococcal InfectionsSpinal and paraspinal pneumococcal infections—a reviewImpact of the 2009 influenza A H1N1 pandemic on invasive pneumococcal disease in adultsThe Epidemiology of Alcohol Abuse and PneumoniaStreptococcal InfectionsThe complex pathogenesis of bacteremiaThe Changing Microbiologic Epidemiology of Community-Acquired PneumoniaEffect of Statin Use on Outcomes of Adults with CandidemiaFactors Influencing Early and Late Mortality in Adults with Invasive Pneumococcal Disease in Calgary, Canada: A Prospective Surveillance StudyThe Spectrum of Invasive Pneumococcal Disease in Adults in the XXI CenturyPneumococcusPneumococcal vaccination of older adultsA nationwide surveillance of invasive pneumococcal disease in adults in Israel before an expected effect of PCV7Long-term Survival Following Pneumococcal PneumoniaEstimating the Burden of Pneumococcal Pneumonia among Adults: A Systematic Review and Meta-Analysis of Diagnostic TechniquesHow Effective is Vaccination in Preventing Pneumococcal Disease?What Is the Relevance of Antimicrobial Resistance on the Outcome of Community-Acquired Pneumonia Caused by Streptococcus pneumoniae? (Should Macrolide Monotherapy Be Used for Mild Pneumonia?)The Impact of Statin and Macrolide Use on Early Survival in Patients With Pneumococcal PneumoniaLooking for new strategies to combat an old foeUnderstanding the roles of cytokines and neutrophil activity and neutrophil apoptosis in the protective versus deleterious inflammatory response in pneumoniaVaccines for preventing pneumococcal infection in adultsA short history of vaccinationPneumococcal polysaccharide vaccinesRisk factors and pathogenic significance of bacteremic pneumonia in adult patients with community-acquired pneumococcal pneumoniaRecurrent Mitral Valve Endocarditis Caused by Streptococcus pneumoniae in a Splenectomized HostTiming of antibiotic administration and outcomes of hospitalized patients with community-acquired and healthcare-associated pneumoniaBacteremia with Streptococcus pneumoniae: sepsis and other risk factors for 30-day mortality—a hospital-based cohort studyA century of pneumococcal vaccination research in humansEntendimento da mortalidade em pneumonia pneumocócica bacterêmicaImpacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócicaChitinase 3-like-1 Promotes Streptococcus pneumoniae Killing and Augments Host Tolerance to Lung Antibacterial ResponsesCritical episodes in the understanding and control of epidemic meningococcal meningitisRecomendações e implementação de diretrizes sobre pneumonia adquirida na comunidade: mais problemas do que soluçõesSerotype-independent pneumococcal experimental vaccines that induce cellular as well as humoral immunityThe Anticipated Severity of a "1918-Like" Influenza Pandemic in Contemporary Populations: The Contribution of Antibacterial InterventionsBiomarqueurs et pneumonie aiguë communautaireNonmultiplying Bacteria are Profoundly Tolerant to AntibioticsWhat is different about serotype 1 pneumococci?Incidence and Cinical Characteristics of Severe Community-Acquired Pneumococcal Pneumonia: Comparisons with Non-Pneumoccocal PathogensVaccination antigrippale et antipneumococcique en pneumologie, chez l'adulte en FranceImmunomodulatory agents in the treatment of community-acquired pneumonia: A systematic reviewOutcomes of hospitalized patients with bacteraemic and non-bacteraemic community-acquired pneumonia caused by Streptococcus pneumoniaeEmerging drugs for pneumococcal pneumoniaImprovement of CRB-65 as a prognostic scoring system in adult patients with bacteraemic pneumococcal pneumoniaFactors affecting the development of systemic inflammatory response syndrome in pneumococcal infectionsDeath or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence typesFactors Predicting Mortality in Invasive Pneumococcal Disease in Adults in AlbertaNeumonía neumocócica: cambios epidemiológicos, diagnósticos y terapéuticosWhy should we measure bacterial load when treating community-acquired pneumonia?Bacterial Polysaccharide VaccinesPneumonia in Children in Developing CountriesInfections communautaires graves — Les pneumonies aiguës communautaires bactériennes de l'adultePrise en charge des pneumonies graves à pneumocoque — Pneumonies communautaires aiguës sévères à Streptococcus pneumoniae (PAC Sp): rôle de l'hôte et des facteurs de virulence bactérienneVaccinesVaccinesInfections respiratoires basses de l'adulteDesign of clinical trials of antibacterial agents for community-acquired bacterial pneumoniaCan we predict which patients with community-acquired pneumonia are likely to have positive blood cultures?Acute Alcohol Intoxication Impairs the Hematopoietic Precursor Cell Response to Pneumococcal PneumoniaPublic health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) in the context of the annual influenza epidemic and a severe influenza pandemicImpact of antibiotic therapy on systemic cytokine expression in pneumococcal pneumoniaThe Spectrum of Invasive Pneumococcal Disease at an Adult Tertiary Care Hospital in the Early 21st CenturyСовременные подходы к профилактике пневмококковой инфекцииMechanisms of Neutrophil Accumulation in the Lungs Against BacteriaBacterial Infections of the Lower Respiratory TractUse of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trialOf mice and men: innate immunity in pneumococcal pneumoniaPolysaccharide VaccinesAcute PneumoniaIntroduction: PneumoniaInfections in Cirrhosis in Critical CareBacteraemic pneumococcal pneumonia in COPD patients: better outcomes than expectedRespiratory infections: A current and future threatPneumococcal Serotypes and Mortality following Invasive Pneumococcal Disease: A Population-Based Cohort StudyTreatment with Protein Synthesis Inhibitors Improves Outcomes of Secondary Bacterial Pneumonia after InfluenzaPneumococcal InfectionsResistance in Streptococcus pneumoniaeCommunity-Acquired Pneumonia Management Based on the PIRO System. A New Therapeutic ParadigmInfluence of Serotype in Pneumococcal Disease: A New Challenge for VaccinationBACTERIAL PNEUMONIASPNEUMOCOCCAL INFECTIONSAustrian's triad complicated by suppurative pericarditis and cardiac tamponade: a case report and review of the literatureEpidemiology of Invasive Pneumococcal Disease among Adult Patients in Barcelona Before and After Pediatric 7‐Valent Pneumococcal Conjugate Vaccine Introduction, 1997–2007Issues in Noninferiority Trials: The Evidence in Community‐Acquired PneumoniaPlacebo‐Controlled Trials of Treatments for Community‐Acquired Pneumonia: Review of the Literature and Discussion of Feasibility and Potential ValueWhat Can We Learn from the Time Course of Untreated and Partially Treated Community‐Onset Streptococcus pneumoniae Pneumonia? A Clinical Perspective on Superiority and Noninferiority Trial Designs for Mild Community‐Acquired PneumoniaClinical Trial Design and Selected Drug Safety Issues for Antibiotics Used to Treat Community‐Acquired PneumoniaClinical and Microbiological End Points in the Treatment of PneumoniaHistorical and Regulatory Perspectives on the Treatment Effect of Antibacterial Drugs for Community‐Acquired PneumoniaPosition Paper: Recommended Design Features of Future Clinical Trials of Antibacterial Agents for Community‐Acquired PneumoniaIs It Possible to Blind a Trial for Community‐Acquired Pneumonia?Invasive pneumococcal infections among persons with and without underlying medical conditions: Implications for prevention strategiesAnimal Models of Streptococcus pneumoniae DiseaseDelay of Active Antimicrobial Therapy and Mortality among Patients with Bacteremia: Impact of Severe NeutropeniaDoxycycline or moxifloxacin for the management of community-acquired pneumonia in the UK?Improving therapeutic strategies for secondary bacterial pneumonia following influenzaBloodstream InfectionsSystemic Expression of Cytokine Production in Patients with Severe Pneumococcal Pneumonia: Effects of Treatment with a β-Lactam versus a FluoroquinoloneAdjunctive therapies for community-acquired pneumonia: a systematic reviewTreatment and Outcomes for Patients With Bacteremic Pneumococcal PneumoniaEditorial Commentary: Reassessing the Design, Conduct, and Analysis of Clinical Trials of Therapy for Community‐Acquired PneumoniaFactors impacting on length of stay and mortality of community-acquired pneumoniaA case for immunization against nosocomial infectionsThe Presence of Pneumococcal Bacteremia Does Not Influence Clinical Outcomes in Patients With Community-Acquired PneumoniaMacrolides in Severe Community-Acquired Pneumonia and SepsisA short history of vaccinationPneumococcal polysaccharide vaccinesPneumococcusReview: Do we need new antibiotics for treating exacerbations of COPD?Ageing and InfectionA Human Monoclonal Immunoglobulin M Reduces Bacteremia and Inflammation in a Mouse Model of Systemic Pneumococcal InfectionInfluence of Neutropenia on the Course of Serotype 8 Pneumococcal Pneumonia in MiceImmunomodulation in SepsisStreptococcal InfectionsAmoxicillin Is Effective against Penicillin-Resistant Streptococcus pneumoniae Strains in a Mouse Pneumonia Model Simulating Human PharmacokineticsSevere pneumococcal pneumonia: new strategies for managementCommunity-acquired pneumonia: How far have we come?Antibiothérapie des pneumonies aiguës communautaires à Streptococcus pneumoniae: impact clinique de la résistance bactérienneAntibiotic Therapy and 48-Hour Mortality for Patients with PneumoniaOptimizing the management of community-acquired respiratory tract infections in the age of antimicrobial resistanceNon-inherited antibiotic resistanceDelayed Administration of Antibiotics and Atypical Presentation in Community-Acquired PneumoniaPrior Pneumococcal Vaccination Is Associated with Reduced Death, Complications, and Length of Stay among Hospitalized Adults with Community-Acquired PneumoniaPhenotypic Characterization of Streptococcus pneumoniae Biofilm DevelopmentPulmonary radiographic findings and mortality in hospitalized patients with lower respiratory tract infectionsPneumococcal Serotypes and VirulenceClinical experience in the management of community-acquired pneumonia: lessons from the use of fluoroquinolonesStreptococcus pneumoniae Bacteremia in Patients With CancerLiens entre résistance et échec dans les infections respiratoires communautairesProgressive and nonresolving pneumoniaThe Controversy of Combination vs Monotherapy in the Treatment of Hospitalized Community-Acquired PneumoniaWhy Do Some Patients Get Severe Pneumonia?Monotherapy versus combination antimicrobial therapy for pneumococcal pneumoniaCannula-associated Staphylococcus aureus bacteraemia: outcome in relation to treatmentAre Blood Cultures Necessary in Community-Acquired Pneumonia?Bacteremic Pneumococcal PneumoniaFactors Influencing In-hospital Mortality in Community-Acquired PneumoniaMonotherapy versus combination antimicrobial therapy for pneumococcal pneumoniaGenetic Susceptibility to PneumoniaEpidemiological differences among pneumococcal serotypesEffect of cirrhosis on antibiotic efficacy in a rat model of pneumococcal pneumoniaChemistry and Biology of Ramoplanin: A Lipoglycodepsipeptide with Potent Antibiotic ActivityProtective Levels of Polysaccharide-Specific May the Response by Pneumococcal in and of pneumococcal A health study in for the treatment of patients with community-acquired pneumonia: and host factors with on new to management of lower respiratory tract of antibody response to pneumococcal capsular polysaccharides in in mortality from invasive Streptococcus Antibiotic Therapy Mortality among Patients with Pneumococcal and analysis of to or resistance in Streptococcus review of clinical with Streptococcus pneumoniaeInvasive Pneumococcal Infections Hospitalized Children in an on current Challenge of Lower Respiratory Tract and Macrolide Resistance in Pneumococcal Pneumonia: Does In Resistance Clinical of antimicrobial resistance in the management of pneumococcal community-acquired Bacteremia: to in the Epidemiology of Pneumococcal Bacteremia in a University Hospital During a Carriage of Streptococcus pneumoniae by Adults and Children in Community and Clinical Trial with for Patients with Community-Acquired Pneumococcal of Community-Acquired Pneumonia Caused by Streptococcus Respiratory InfectionsThe Clinical Significance of Streptococcus pneumoniae: of Mice with against Streptococcus pneumoniae in community-acquired pneumoniaA to Macrolide pneumococcal infections in patients without the impact of resistance on Commentary: is Antimicrobial Therapy for Bacteremic Pneumococcal of Pneumococcal Polysaccharide Review of in the Management of Patients with Community-Acquired and J. Pneumococcal Endocarditis and that and Resistance to en la for the Treatment of Community-Acquired Pneumonia in vaccination en chez future the development of new antimicrobial infections: of the School of Disease on 3 in Pneumococcal Implications for the of Pneumococcal Conjugate of Macrolide Antibiotic Treatment in Patients with Bacteremia to Streptococcus of Pneumococcal Pneumonia in in of pneumococcal disease in HIV-infected mortality and with Pneumococcal Conjugate Vaccines with a of as against Pneumococcal Infections in and pneumococcal pneumonia: treatment with and les pneumonies communautaires à pneumocoque chez des in lower respiratory tract infections and the impact of antimicrobial the of to Streptococcus Infection due to Streptococcus of appropriate antibiotic use for treatment of respiratory tract infections in specific and of Antibiotic Use for Treatment of Respiratory Tract Infections in Adults: and J. and A. and COPD in Severe Community-Acquired anti-pneumococcique: place et dans la des infections communautaires des respiratoires of and specific antibody on bacterial and in experimental pneumococcal pneumoniaThe of the severity of community-acquired pneumonia on the of blood Urinary Antigen for the of Pneumococcal of Streptococcus pneumoniae in the United Antibiotic and pneumococcal a factors for community-acquired pneumonia pneumococcal disease in the of pneumonia and bacteremia model in mice for the analysis of protective and Pneumococcal Pneumonia A Prospective StudyThe of Bacteria in of infections in patients: Diagnostic and therapeutic from Pneumonia in Children in the United States, of Mortality in Pneumococcal and risk factors for mortality among adults with pneumonia in of the of Blood Cultures or from Patients with Early and of respiratory of pneumococcal capsular conjugate vaccines new and response of pneumococcal need for from invasive pneumococcal pneumonia in the of antibiotic Cultures for Community-Acquired of Streptococcus pneumoniae by capsular and in Patients: of in Patients: of of pneumococcal pneumonia: the case for disease in and current of invasive pneumococcal for pneumococcal infection at the and current and future and the Does Not the or of or in a Model of Pneumococcal Against Streptococcus of Pneumonia in Pneumonia and Bacteremia in a Endocarditis Caused by Streptococcus for New Vaccine with on Pneumococcal Protein A vaccination in adults in of

@article{doi10732600034819605759,
    author = "Austrian, Robert and GOLD, JEROME",
    title = "Pneumococcal Bacteremia with Especial Reference to Bacteremic Pneumococcal Pneumonia",
    year = "1964",
    journal = "Annals of Internal Medicine",
    abstract = {Article1 May 1964Pneumococcal Bacteremia with Especial Reference to Bacteremic Pneumococcal PneumoniaROBERT AUSTRIAN, M.D., JEROME GOLD, M.D.ROBERT AUSTRIAN, M.D., JEROME GOLD, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-5-759 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTwenty-five years have elapsed since the subject of pneumococcal bacteremia has been reviewed (1, 2). In that period many changes have taken place both in the treatment of this disorder and in the attitude of the medical profession toward it. The introduction of a series of antimicrobial drugs effective against all capsular types of pneumococcus has led to widespread abandonment of the more precise bacteriologic techniques designed for the recognition of this organism and secondarily to the impression that pneumococcal disease no longer constitutes a serious medical problem. To determine the validity of these practices and attitudes, established techniques for...References1. TILGHMANFINLAND RCM: Clinical significance of bacteremia in pneumococcal pneumonia. Arch. Intern. Med. (Chicago) 59: 602, 1937. CrossrefGoogle Scholar2. BULLOWA JG: The Management of the Pneumonias, Oxford University Press, New York, 1937. Google Scholar3. MACLEODAUSTRIANFINLAND CMRM: Pneumococcus, in Diagnostic Procedures and Reagents, American Public Health Association, New York, 1963, pp. 222-30. Google Scholar4. Statistical Abstract of the United States, 1958, 79th Annual Edition: U. S. Department of Commerce, Bureau of the Census, U. S. Government Printing Office, Washington, D. C., 1958, p. 6. Google Scholar5. DINGLEBADGERFELLERHODGESJORDANRAMMELKAMP JHGFAERGWSCH: A study of illness in a group of Cleveland families. I. Plan of study and certain general observations. Amer. J. Hyg. 58: 16, 1953. MedlineGoogle Scholar6. REIMANN HA: Current problems of the pneumonias. Ann. Intern. Med. 56: 144, 1962. LinkGoogle Scholar7. Advance Report, Vital Statistics of the United States, 1961. Final Natality and Mortality Statistics: National Vital Statistics Division, Department of Health, Education, and Welfare, United States Public Health Service, Nov., 1962. Google Scholar8. WOODSMITH WBMR: The inhibition of surface phagocytosis by the capsular "slime layer" of pneumococcus Type III. J. Exp. Med. 90: 85, 1949. CrossrefMedlineGoogle Scholar9. WOODSMITH WBMR: Host-parasite relationships in experimental pneumonia due to pneumococcus Type III. J. Exp. Med. 92: 85, 1950. CrossrefMedlineGoogle Scholar10. BALCH HH: Relation of nutritional deficiency in man to antibody production. J. Immun. 64: 397, 1950. MedlineGoogle Scholar11. BALCHSPENCER HHMT: Phagocytosis by human leukocytes. II. Relation of nutritional deficiency in man to phagocytosis. J. Clin. Invest. 33: 1321, 1954. CrossrefMedlineGoogle Scholar12. JETERMCKEEMASON WSAPRJ: Inhibition of immune phagocytosis of Diplococcus pneumoniae by human neutrophiles with antibody against complement. J. Immun. 86: 386, 1961. MedlineGoogle Scholar13. DOWLINGLEPPER HFMH: The effect of antibiotics (Penicillin, Aureomycin, and Terramycin) on the fatality rate and incidence of complications in pneumococcic pneumonia. Amer. J. Med. Sci. 222: 396, 1951. CrossrefMedlineGoogle Scholar14. MACLEODHODGESHEIDELBERGERBERNHARD CMRGMWG: Prevention of pneumococcal pneumonia by immunization with specific capsular polysaccharides. J. Exp. Med. 82: 445, 1945. CrossrefGoogle Scholar15. KAUFMAN P: Pneumonia in old age. Arch. Intern. Med. (Chicago) 79: 518, 1947. CrossrefGoogle Scholar16. HEIDELBERGER M: Persistence of antibodies in man after immunization, in The Nature and Significance of the Antibody Response, edited by PAPPENHEIMER, A. M., JR., Columbia University Press, New York, 1953, pp. 90-101. Google Scholar17. HEIDELBERGERMACLEODDI LAPI MCMM: The human antibody response to simultaneous injection of six specific polysaccharides of pneumococcus. J. Exp. Med. 88: 369, 1948. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, PennsylvaniaFrom the Department of Medicine, State University of New York Downstate Medical Center, the Medical Service of Kings County Hospital, Brooklyn, New York, and the Department of Research Medicine, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.These data were presented in part at the 76th Session of the Association of American Physicians, April 30, 1963.Requests for reprints should be addressed to Robert Austrian, M.D., Hospital of the University of Pennsylvania, Philadelphia 4, Pennsylvania. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEffects of Aging and Associated Conditions on Humoral Responses to Respiratory Tract InfectionsClinical Features and Outcomes of Streptococcus pneumoniae Meningitis in Children: A Retrospective Analysis of 26 Cases in ChinaBioassay- and QSAR-based screening of toxic transformation products and their formation under chlorination treatment on levofloxacinComparing scoring systems for prediction of mortality in patients with bloodstream infectionCardiovascular complications of Streptococcus pneumoniae bacteraemiaLower Density and Shorter Duration of Nasopharyngeal Carriage by Pneumococcal Serotype 1 (ST217) May Explain Its Increased Invasiveness over Other SerotypesGastrointestinal symptoms in invasive pneumococcal disease: a cohort studyEffectiveness of Streptococcus Pneumoniae Urinary Antigen Testing in Decreasing Mortality of COVID-19 Co-Infected Patients: A Clinical InvestigationB Cell ImmunosenescenceFormulation technologies and advances for oral delivery of novel nitroimidazoles and antimicrobial peptidesPneumococcal Vaccines for Adults: What's Next?Pneumococcal VaccinesNext-Generation Whole-Cell Pneumococcal VaccinePneumococcal VaccinesInfluence of Obesity on Pneumococcus Infection Risk in the ElderlyPneumococcal Community-Acquired Pneumonia Detected by Serotype-Specific Urinary Antigen Detection AssaysEarly administration of appropriate antimicrobial agents to improve the outcome of carbapenem-resistant Acinetobacter baumannii complex bacteraemic pneumoniaA Short History of VaccinationPneumococcal Polysaccharide VaccinesA Perfect Storm: Increased Colonization and Failure of Vaccination Leads to Severe Secondary Bacterial Infection in Influenza Virus-Infected Obese MiceStreptococcus pneumoniae antimicrobial resistance decreased in the Helsinki Metropolitan Area after routine 10-valent pneumococcal conjugate vaccination of infants in FinlandTime to antibiotics administration and outcome in community-acquired pneumonia: Secondary analysis of a randomized controlled trialCombination therapy with ampicillin and azithromycin improved outcomes in a mouse model of group B streptococcal sepsisTyk2 as a target for immune regulation in human viral/bacterial pneumoniaConcurrent Infection with Hepatitis C Virus and Streptococcus pneumoniaeComparative evaluation of a newly developed 13-valent pneumococcal conjugate vaccine in a mouse modelWhite Blood Cell Counts, Alcoholism, and Cirrhosis in Pneumococcal PneumoniaResistance in Streptococcus pneumoniaeInvasive Pneumococcal Disease: Still Lots to Learn and a Need for Standardized Data Collection InstrumentsA 32-Year Study of the Effect of Pneumococcal Vaccines on Invasive Streptococcus pneumoniae DiseaseDectin-2-dependent host defense in mice infected with serotype 3 Streptococcus pneumoniaeDetermination of neutrophil CD64 expression as a prognostic biomarker in patients with community-acquired pneumoniaAntimicrobial stewardship in South Africa: a fruitful endeavourPredictive and prognostic factors in patients with blood-culture-positive community-acquired pneumococcal pneumoniaPredictors and Implications of Early Clinical Stability in Patients Hospitalized for Moderately Severe Community-Acquired PneumoniaPneumococcal Vaccination Strategies. An Update and PerspectiveThe impact of global budgeting on health service utilization, health care expenditures, and quality of care among patients with pneumonia in TaiwanAdjunctive Corticotherapy for Community Acquired Pneumonia: A Systematic Review and Meta-AnalysisMacrophage Migration Inhibitory Factor Is Detrimental in Pneumococcal Pneumonia and a Target for Therapeutic ImmunomodulationBlood culture fluorescence rates predict severity and mortality of invasive pneumococcal pneumoniaThe problem of early mortality in pneumococcal pneumonia: a study of risk factorsGlucocorticoid-Augmented Efferocytosis Inhibits Pulmonary Pneumococcal Clearance in Mice by Reducing Alveolar Macrophage Bactericidal FunctionAntibiotic resistancePneumonie – "The old man's friend"Antiinfektive Erstherapie bei SepsisAcute PneumoniaStreptococcus pneumoniaePrevention of Streptococcus pneumoniae (pneumococcal) infections in adultsAntiinfektive Erstherapie bei SepsisReasons for adult immunization – Prevention of most frequent respiratory infectionsPneumococcal Vaccine and Patients with Pulmonary DiseasesA Leukocyte Score to Improve Clinical Outcome Predictions in Bacteremic Pneumococcal Pneumonia in AdultsPneumococcal colonisation density: a new marker for disease severity in HIV-infected adults with pneumoniaVaccination anti-pneumococcique chez l'adulte: comment améliorer la couverture vaccinale?Differences in serious clinical outcomes of infection caused by specific pneumococcal serotypes among adultsAdjunctive Corticosteroid Therapy Improves Lung Immunopathology and Survival During Severe Secondary Pneumococcal Pneumonia in MiceThe Pneumococcus: Population Biology and VirulenceThe History of Pneumococcal DiseaseHistory of Pneumococcal ImmunizationPneumococcal Pneumonia in Adults: Epidemiology, Clinical Features, Diagnosis, and TherapyPneumococcal VaccinesAttachment and Invasion of the Respiratory TractImmunodeficiency and Invasive Pneumococcal DiseaseClinical Relevance of Antibiotic Resistance in Pneumococcal InfectionsSpinal and paraspinal pneumococcal infections—a reviewImpact of the 2009 influenza A H1N1 pandemic on invasive pneumococcal disease in adultsThe Epidemiology of Alcohol Abuse and PneumoniaStreptococcal InfectionsThe complex pathogenesis of bacteremiaThe Changing Microbiologic Epidemiology of Community-Acquired PneumoniaEffect of Statin Use on Outcomes of Adults with CandidemiaFactors Influencing Early and Late Mortality in Adults with Invasive Pneumococcal Disease in Calgary, Canada: A Prospective Surveillance StudyThe Spectrum of Invasive Pneumococcal Disease in Adults in the XXI CenturyPneumococcusPneumococcal vaccination of older adultsA nationwide surveillance of invasive pneumococcal disease in adults in Israel before an expected effect of PCV7Long-term Survival Following Pneumococcal PneumoniaEstimating the Burden of Pneumococcal Pneumonia among Adults: A Systematic Review and Meta-Analysis of Diagnostic TechniquesHow Effective is Vaccination in Preventing Pneumococcal Disease?What Is the Relevance of Antimicrobial Resistance on the Outcome of Community-Acquired Pneumonia Caused by Streptococcus pneumoniae? (Should Macrolide Monotherapy Be Used for Mild Pneumonia?)The Impact of Statin and Macrolide Use on Early Survival in Patients With Pneumococcal PneumoniaLooking for new strategies to combat an old foeUnderstanding the roles of cytokines and neutrophil activity and neutrophil apoptosis in the protective versus deleterious inflammatory response in pneumoniaVaccines for preventing pneumococcal infection in adultsA short history of vaccinationPneumococcal polysaccharide vaccinesRisk factors and pathogenic significance of bacteremic pneumonia in adult patients with community-acquired pneumococcal pneumoniaRecurrent Mitral Valve Endocarditis Caused by Streptococcus pneumoniae in a Splenectomized HostTiming of antibiotic administration and outcomes of hospitalized patients with community-acquired and healthcare-associated pneumoniaBacteremia with Streptococcus pneumoniae: sepsis and other risk factors for 30-day mortality—a hospital-based cohort studyA century of pneumococcal vaccination research in humansEntendimento da mortalidade em pneumonia pneumocócica bacterêmicaImpacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócicaChitinase 3-like-1 Promotes Streptococcus pneumoniae Killing and Augments Host Tolerance to Lung Antibacterial ResponsesCritical episodes in the understanding and control of epidemic meningococcal meningitisRecomendações e implementação de diretrizes sobre pneumonia adquirida na comunidade: mais problemas do que soluçõesSerotype-independent pneumococcal experimental vaccines that induce cellular as well as humoral immunityThe Anticipated Severity of a "1918-Like" Influenza Pandemic in Contemporary Populations: The Contribution of Antibacterial InterventionsBiomarqueurs et pneumonie aiguë communautaireNonmultiplying Bacteria are Profoundly Tolerant to AntibioticsWhat is different about serotype 1 pneumococci?Incidence and Cinical Characteristics of Severe Community-Acquired Pneumococcal Pneumonia: Comparisons with Non-Pneumoccocal PathogensVaccination antigrippale et antipneumococcique en pneumologie, chez l'adulte en FranceImmunomodulatory agents in the treatment of community-acquired pneumonia: A systematic reviewOutcomes of hospitalized patients with bacteraemic and non-bacteraemic community-acquired pneumonia caused by Streptococcus pneumoniaeEmerging drugs for pneumococcal pneumoniaImprovement of CRB-65 as a prognostic scoring system in adult patients with bacteraemic pneumococcal pneumoniaFactors affecting the development of systemic inflammatory response syndrome in pneumococcal infectionsDeath or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence typesFactors Predicting Mortality in Invasive Pneumococcal Disease in Adults in AlbertaNeumonía neumocócica: cambios epidemiológicos, diagnósticos y terapéuticosWhy should we measure bacterial load when treating community-acquired pneumonia?Bacterial Polysaccharide VaccinesPneumonia in Children in Developing CountriesInfections communautaires graves — Les pneumonies aiguës communautaires bactériennes de l'adultePrise en charge des pneumonies graves à pneumocoque — Pneumonies communautaires aiguës sévères à Streptococcus pneumoniae (PAC Sp): rôle de l'hôte et des facteurs de virulence bactérienneVaccinesVaccinesInfections respiratoires basses de l'adulteDesign of clinical trials of antibacterial agents for community-acquired bacterial pneumoniaCan we predict which patients with community-acquired pneumonia are likely to have positive blood cultures?Acute Alcohol Intoxication Impairs the Hematopoietic Precursor Cell Response to Pneumococcal PneumoniaPublic health and economic impact of vaccination with 7-valent pneumococcal vaccine (PCV7) in the context of the annual influenza epidemic and a severe influenza pandemicImpact of antibiotic therapy on systemic cytokine expression in pneumococcal pneumoniaThe Spectrum of Invasive Pneumococcal Disease at an Adult Tertiary Care Hospital in the Early 21st CenturyСовременные подходы к профилактике пневмококковой инфекцииMechanisms of Neutrophil Accumulation in the Lungs Against BacteriaBacterial Infections of the Lower Respiratory TractUse of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trialOf mice and men: innate immunity in pneumococcal pneumoniaPolysaccharide VaccinesAcute PneumoniaIntroduction: PneumoniaInfections in Cirrhosis in Critical CareBacteraemic pneumococcal pneumonia in COPD patients: better outcomes than expectedRespiratory infections: A current and future threatPneumococcal Serotypes and Mortality following Invasive Pneumococcal Disease: A Population-Based Cohort StudyTreatment with Protein Synthesis Inhibitors Improves Outcomes of Secondary Bacterial Pneumonia after InfluenzaPneumococcal InfectionsResistance in Streptococcus pneumoniaeCommunity-Acquired Pneumonia Management Based on the PIRO System. A New Therapeutic ParadigmInfluence of Serotype in Pneumococcal Disease: A New Challenge for VaccinationBACTERIAL PNEUMONIASPNEUMOCOCCAL INFECTIONSAustrian's triad complicated by suppurative pericarditis and cardiac tamponade: a case report and review of the literatureEpidemiology of Invasive Pneumococcal Disease among Adult Patients in Barcelona Before and After Pediatric 7‐Valent Pneumococcal Conjugate Vaccine Introduction, 1997–2007Issues in Noninferiority Trials: The Evidence in Community‐Acquired PneumoniaPlacebo‐Controlled Trials of Treatments for Community‐Acquired Pneumonia: Review of the Literature and Discussion of Feasibility and Potential ValueWhat Can We Learn from the Time Course of Untreated and Partially Treated Community‐Onset Streptococcus pneumoniae Pneumonia? A Clinical Perspective on Superiority and Noninferiority Trial Designs for Mild Community‐Acquired PneumoniaClinical Trial Design and Selected Drug Safety Issues for Antibiotics Used to Treat Community‐Acquired PneumoniaClinical and Microbiological End Points in the Treatment of PneumoniaHistorical and Regulatory Perspectives on the Treatment Effect of Antibacterial Drugs for Community‐Acquired PneumoniaPosition Paper: Recommended Design Features of Future Clinical Trials of Antibacterial Agents for Community‐Acquired PneumoniaIs It Possible to Blind a Trial for Community‐Acquired Pneumonia?Invasive pneumococcal infections among persons with and without underlying medical conditions: Implications for prevention strategiesAnimal Models of Streptococcus pneumoniae DiseaseDelay of Active Antimicrobial Therapy and Mortality among Patients with Bacteremia: Impact of Severe NeutropeniaDoxycycline or moxifloxacin for the management of community-acquired pneumonia in the UK?Improving therapeutic strategies for secondary bacterial pneumonia following influenzaBloodstream InfectionsSystemic Expression of Cytokine Production in Patients with Severe Pneumococcal Pneumonia: Effects of Treatment with a β-Lactam versus a FluoroquinoloneAdjunctive therapies for community-acquired pneumonia: a systematic reviewTreatment and Outcomes for Patients With Bacteremic Pneumococcal PneumoniaEditorial Commentary: Reassessing the Design, Conduct, and Analysis of Clinical Trials of Therapy for Community‐Acquired PneumoniaFactors impacting on length of stay and mortality of community-acquired pneumoniaA case for immunization against nosocomial infectionsThe Presence of Pneumococcal Bacteremia Does Not Influence Clinical Outcomes in Patients With Community-Acquired PneumoniaMacrolides in Severe Community-Acquired Pneumonia and SepsisA short history of vaccinationPneumococcal polysaccharide vaccinesPneumococcusReview: Do we need new antibiotics for treating exacerbations of COPD?Ageing and InfectionA Human Monoclonal Immunoglobulin M Reduces Bacteremia and Inflammation in a Mouse Model of Systemic Pneumococcal InfectionInfluence of Neutropenia on the Course of Serotype 8 Pneumococcal Pneumonia in MiceImmunomodulation in SepsisStreptococcal InfectionsAmoxicillin Is Effective against Penicillin-Resistant Streptococcus pneumoniae Strains in a Mouse Pneumonia Model Simulating Human PharmacokineticsSevere pneumococcal pneumonia: new strategies for managementCommunity-acquired pneumonia: How far have we come?Antibiothérapie des pneumonies aiguës communautaires à Streptococcus pneumoniae: impact clinique de la résistance bactérienneAntibiotic Therapy and 48-Hour Mortality for Patients with PneumoniaOptimizing the management of community-acquired respiratory tract infections in the age of antimicrobial resistanceNon-inherited antibiotic resistanceDelayed Administration of Antibiotics and Atypical Presentation in Community-Acquired PneumoniaPrior Pneumococcal Vaccination Is Associated with Reduced Death, Complications, and Length of Stay among Hospitalized Adults with Community-Acquired PneumoniaPhenotypic Characterization of Streptococcus pneumoniae Biofilm DevelopmentPulmonary radiographic findings and mortality in hospitalized patients with lower respiratory tract infectionsPneumococcal Serotypes and VirulenceClinical experience in the management of community-acquired pneumonia: lessons from the use of fluoroquinolonesStreptococcus pneumoniae Bacteremia in Patients With CancerLiens entre résistance et échec dans les infections respiratoires communautairesProgressive and nonresolving pneumoniaThe Controversy of Combination vs Monotherapy in the Treatment of Hospitalized Community-Acquired PneumoniaWhy Do Some Patients Get Severe Pneumonia?Monotherapy versus combination antimicrobial therapy for pneumococcal pneumoniaCannula-associated Staphylococcus aureus bacteraemia: outcome in relation to treatmentAre Blood Cultures Necessary in Community-Acquired Pneumonia?Bacteremic Pneumococcal PneumoniaFactors Influencing In-hospital Mortality in Community-Acquired PneumoniaMonotherapy versus combination antimicrobial therapy for pneumococcal pneumoniaGenetic Susceptibility to PneumoniaEpidemiological differences among pneumococcal serotypesEffect of cirrhosis on antibiotic efficacy in a rat model of pneumococcal pneumoniaChemistry and Biology of Ramoplanin: A Lipoglycodepsipeptide with Potent Antibiotic ActivityProtective Levels of Polysaccharide-Specific May the Response by Pneumococcal in and of pneumococcal A health study in for the treatment of patients with community-acquired pneumonia: and host factors with on new to management of lower respiratory tract of antibody response to pneumococcal capsular polysaccharides in in mortality from invasive Streptococcus Antibiotic Therapy Mortality among Patients with Pneumococcal and analysis of to or resistance in Streptococcus review of clinical with Streptococcus pneumoniaeInvasive Pneumococcal Infections Hospitalized Children in an on current Challenge of Lower Respiratory Tract and Macrolide Resistance in Pneumococcal Pneumonia: Does In Resistance Clinical of antimicrobial resistance in the management of pneumococcal community-acquired Bacteremia: to in the Epidemiology of Pneumococcal Bacteremia in a University Hospital During a Carriage of Streptococcus pneumoniae by Adults and Children in Community and Clinical Trial with for Patients with Community-Acquired Pneumococcal of Community-Acquired Pneumonia Caused by Streptococcus Respiratory InfectionsThe Clinical Significance of Streptococcus pneumoniae: of Mice with against Streptococcus pneumoniae in community-acquired pneumoniaA to Macrolide pneumococcal infections in patients without the impact of resistance on Commentary: is Antimicrobial Therapy for Bacteremic Pneumococcal of Pneumococcal Polysaccharide Review of in the Management of Patients with Community-Acquired and J. Pneumococcal Endocarditis and that and Resistance to en la for the Treatment of Community-Acquired Pneumonia in vaccination en chez future the development of new antimicrobial infections: of the School of Disease on 3 in Pneumococcal Implications for the of Pneumococcal Conjugate of Macrolide Antibiotic Treatment in Patients with Bacteremia to Streptococcus of Pneumococcal Pneumonia in in of pneumococcal disease in HIV-infected mortality and with Pneumococcal Conjugate Vaccines with a of as against Pneumococcal Infections in and pneumococcal pneumonia: treatment with and les pneumonies communautaires à pneumocoque chez des in lower respiratory tract infections and the impact of antimicrobial the of to Streptococcus Infection due to Streptococcus of appropriate antibiotic use for treatment of respiratory tract infections in specific and of Antibiotic Use for Treatment of Respiratory Tract Infections in Adults: and J. and A. and COPD in Severe Community-Acquired anti-pneumococcique: place et dans la des infections communautaires des respiratoires of and specific antibody on bacterial and in experimental pneumococcal pneumoniaThe of the severity of community-acquired pneumonia on the of blood Urinary Antigen for the of Pneumococcal of Streptococcus pneumoniae in the United Antibiotic and pneumococcal a factors for community-acquired pneumonia pneumococcal disease in the of pneumonia and bacteremia model in mice for the analysis of protective and Pneumococcal Pneumonia A Prospective StudyThe of Bacteria in of infections in patients: Diagnostic and therapeutic from Pneumonia in Children in the United States, of Mortality in Pneumococcal and risk factors for mortality among adults with pneumonia in of the of Blood Cultures or from Patients with Early and of respiratory of pneumococcal capsular conjugate vaccines new and response of pneumococcal need for from invasive pneumococcal pneumonia in the of antibiotic Cultures for Community-Acquired of Streptococcus pneumoniae by capsular and in Patients: of in Patients: of of pneumococcal pneumonia: the case for disease in and current of invasive pneumococcal for pneumococcal infection at the and current and future and the Does Not the or of or in a Model of Pneumococcal Against Streptococcus of Pneumonia in Pneumonia and Bacteremia in a Endocarditis Caused by Streptococcus for New Vaccine with on Pneumococcal Protein A vaccination in adults in of},
    url = "https://doi.org/10.7326/0003-4819-60-5-759",
    doi = "10.7326/0003-4819-60-5-759",
    openalex = "W2069992170"
}

Mice produce litters containing many pups, and the female fetuses that develop between male fetuses have significantly higher concentrations of the male sex steroid testosterone in both their blood and amniotic fluid than do females that develop between other female fetuses. These two types of females differ during later life in many sexually related characteristics. Thus, individual variation in sexual characteristics of adult female mice may be traceable to differential exposure to testosterone during prenatal development because of intrauterine proximity to male fetuses.

@article{doi101126science7367881,
    author = "vom Saal, Frederick S. and Bronson, F. H.",
    title = "Sexual Characteristics of Adult Female Mice Are Correlated with Their Blood Testosterone Levels During Prenatal Development",
    year = "1980",
    journal = "Science",
    abstract = "Mice produce litters containing many pups, and the female fetuses that develop between male fetuses have significantly higher concentrations of the male sex steroid testosterone in both their blood and amniotic fluid than do females that develop between other female fetuses. These two types of females differ during later life in many sexually related characteristics. Thus, individual variation in sexual characteristics of adult female mice may be traceable to differential exposure to testosterone during prenatal development because of intrauterine proximity to male fetuses.",
    url = "https://doi.org/10.1126/science.7367881",
    doi = "10.1126/science.7367881",
    openalex = "W2000841514",
    references = "doi1010160018506x78900235, doi1010160018506x79900217, doi101095biolreprod194842, doi101095biolreprod224777, doi101210endo1013939, doi101210endo754627, doi101210endo8251010, doi101210endo9461658, doi103181003797278520989, openalexw2418560464"
}

@article{doi101016s0140673682903348,
    author = "Macfarlane, J T and Ward, M.J. and Finch, R. and Macrae, A.D.",
    title = "HOSPITAL STUDY OF ADULT COMMUNITY-ACQUIRED PNEUMONIA",
    year = "1982",
    journal = "The Lancet",
    url = "https://doi.org/10.1016/s0140-6736(82)90334-8",
    doi = "10.1016/s0140-6736(82)90334-8",
    openalex = "W2087064240"
}

Hospital-acquired pneumonia was studied prospectively for 3 1/2 years in a 549-bed facility with acute medical-surgical care wards, convalescent wards, and a chronic care unit. Bacteriological studies were limited to transtracheal aspirates, pleural fluid, and blood cultures. The predominant isolates in 159 patients were gram-negative bacilli (47%), anaerobic bacteria (35%), Staphylococcus aureus (31%), and Streptococcus pneumoniae (26%). Nearly half of all specimens yielded a polymicrobial flora with more than one potential pathogen. Distribution of pathogens was similar with analysis of all patients, including patients with a monomicrobial infection and patients with bacteremic pneumonia. The prevalence of cases and distribution of bacteria were similar for patients located on acute medical-surgical wards and those in the nursing home care unit. Nosocomial pneumonia was judged directly responsible for lethal outcome in 19% of patients and a contributing factor to death in another 13%.

@article{doi101001archinte198600360170064009,
    author = "Bartlett, John G.",
    title = "Bacteriology of Hospital-Acquired Pneumonia",
    year = "1986",
    journal = "Archives of Internal Medicine",
    abstract = "Hospital-acquired pneumonia was studied prospectively for 3 1/2 years in a 549-bed facility with acute medical-surgical care wards, convalescent wards, and a chronic care unit. Bacteriological studies were limited to transtracheal aspirates, pleural fluid, and blood cultures. The predominant isolates in 159 patients were gram-negative bacilli (47\%), anaerobic bacteria (35\%), Staphylococcus aureus (31\%), and Streptococcus pneumoniae (26\%). Nearly half of all specimens yielded a polymicrobial flora with more than one potential pathogen. Distribution of pathogens was similar with analysis of all patients, including patients with a monomicrobial infection and patients with bacteremic pneumonia. The prevalence of cases and distribution of bacteria were similar for patients located on acute medical-surgical wards and those in the nursing home care unit. Nosocomial pneumonia was judged directly responsible for lethal outcome in 19\% of patients and a contributing factor to death in another 13\%.",
    url = "https://doi.org/10.1001/archinte.1986.00360170064009",
    doi = "10.1001/archinte.1986.00360170064009",
    openalex = "W2064497659"
}

Journal Article Community-acquired Pneumonia in Adults in British Hospitals in 1982–1983: A Survey of Aetiology, Mortality, Prognostic Factors and Outcome Get access This study was organised by a subcommittee of the Research Committee of the British Thoracic Society and the Public Health Laboratory Service This study was organised by a subcommittee of the Research Committee of the British Thoracic Society and the Public Health Laboratory Service Search for other works by this author on: Oxford Academic PubMed Google Scholar QJM: An International Journal of Medicine, Volume 62, Issue 3, March 1987, Pages 195–220, https://doi.org/10.1093/oxfordjournals.qjmed.a068093 Published: 01 March 1987 Article history Accepted: 04 September 1986 Published: 01 March 1987

@article{doi101093oxfordjournalsqjmeda068093,
    author = "study was organised by a subcommittee of the Research Committee of the British Thoracic Society, This and the Public Health Laboratory Service",
    title = "Community-acquired Pneumonia in Adults in British Hospitals in 1982–1983: A Survey of Aetiology, Mortality, Prognostic Factors and Outcome",
    year = "1987",
    journal = "QJM",
    abstract = "Journal Article Community-acquired Pneumonia in Adults in British Hospitals in 1982–1983: A Survey of Aetiology, Mortality, Prognostic Factors and Outcome Get access This study was organised by a subcommittee of the Research Committee of the British Thoracic Society and the Public Health Laboratory Service This study was organised by a subcommittee of the Research Committee of the British Thoracic Society and the Public Health Laboratory Service Search for other works by this author on: Oxford Academic PubMed Google Scholar QJM: An International Journal of Medicine, Volume 62, Issue 3, March 1987, Pages 195–220, https://doi.org/10.1093/oxfordjournals.qjmed.a068093 Published: 01 March 1987 Article history Accepted: 04 September 1986 Published: 01 March 1987",
    url = "https://doi.org/10.1093/oxfordjournals.qjmed.a068093",
    doi = "10.1093/oxfordjournals.qjmed.a068093",
    openalex = "W4244439913"
}

We studied all patients with community-acquired pneumonia who were admitted to our 800-bed adult acute care hospital from 1 November 1981 to 15 March 1987. The 719 patients had a mean age of 63.2 years; 18% were admitted from nursing homes, and 18% required ventilatory assistance as part of the therapy for pneumonia. Patients with nursing home-acquired pneumonia were significantly older; had a higher mortality (40% vs. 17%); were more likely to be admitted in January; were less likely to complain of cough, fever, anorexia, chills, headache, nausea, sore throat, myalgia, or arthralgia; and were more likely to be confused than those admitted from the community. Pneumonia of unknown etiology and aspiration pneumonia were more common and Mycoplasma pneumoniae infection less common among those with nursing home-acquired pneumonia. Streptococcus pneumoniae accounted for 58% of the 48 cases of bacteremia. None of the bacteremic patients received antibiotics before admission, compared with 34% of the nonbacteremic patients. Aerobic gram-negative rod bacteremia was not more frequent among nursing home patients than among those from the community. The overall mortality was 21% (8.5% for those less than 60 years of age and 28.6% for those greater than 60 years old). By multivariate analysis the following variables were significant predictors of mortality: number of lobes involved by the pneumonic process, number of antibiotics used to treat the pneumonia, age, admission from a nursing home, ventilatory support, and the number of complications that occurred while the patient was in the hospital.

@article{doi101093clinids114586,
    author = "Marrie, T. J. and Durant, Heather and Yates, Lynda",
    title = "Community-Acquired Pneumonia Requiring Hospitalization: 5-Year Prospective Study",
    year = "1989",
    journal = "Clinical Infectious Diseases",
    abstract = "We studied all patients with community-acquired pneumonia who were admitted to our 800-bed adult acute care hospital from 1 November 1981 to 15 March 1987. The 719 patients had a mean age of 63.2 years; 18\% were admitted from nursing homes, and 18\% required ventilatory assistance as part of the therapy for pneumonia. Patients with nursing home-acquired pneumonia were significantly older; had a higher mortality (40\% vs. 17\%); were more likely to be admitted in January; were less likely to complain of cough, fever, anorexia, chills, headache, nausea, sore throat, myalgia, or arthralgia; and were more likely to be confused than those admitted from the community. Pneumonia of unknown etiology and aspiration pneumonia were more common and Mycoplasma pneumoniae infection less common among those with nursing home-acquired pneumonia. Streptococcus pneumoniae accounted for 58\% of the 48 cases of bacteremia. None of the bacteremic patients received antibiotics before admission, compared with 34\% of the nonbacteremic patients. Aerobic gram-negative rod bacteremia was not more frequent among nursing home patients than among those from the community. The overall mortality was 21\% (8.5\% for those less than 60 years of age and 28.6\% for those greater than 60 years old). By multivariate analysis the following variables were significant predictors of mortality: number of lobes involved by the pneumonic process, number of antibiotics used to treat the pneumonia, age, admission from a nursing home, ventilatory support, and the number of complications that occurred while the patient was in the hospital.",
    url = "https://doi.org/10.1093/clinids/11.4.586",
    doi = "10.1093/clinids/11.4.586",
    openalex = "W2091953741"
}

Three hundred fifty-nine consecutive patients with community-acquired pneumonia admitted to university, community, and VA hospitals underwent a standardized evaluation, including specialized tests for Legionella spp. and Chlamydia pneumoniae (TWAR). The most common underlying illnesses were immunosuppression (36.3%), chronic obstructive pulmonary disease (32.4%), and malignancy (28.4%). The most frequent etiologic agents were Streptococcus pneumoniae (15.3%) and Hemophilus influenzae (10.9%). Surprisingly, Legionella spp. and C. pneumoniae were the third and fourth most frequent etiologies at 6.7% and 6.1%, respectively. Aerobic gram-negative pneumonias were relatively uncommon causes of pneumonia despite the fact that empiric broad-spectrum combination antibiotic therapy is so often directed at this subgroup. In 32.9%, the etiology was undetermined. Antibiotic administration before admission was significantly associated with undetermined etiology (p = 0.0003). There were no distinctive clinical features found to be diagnostic for any etiologic agent, although high fever occurred more frequently in Legionnaires' disease. Clinical manifestations for C. pneumoniae were generally mild, although 38% of patients had mental status changes. Mortality was highest for Staphylococcus aureus (50%) and lowest for C. pneumoniae (4.5%) and Mycoplasma pneumoniae (0%). We document that specialized laboratory testing for C. pneumoniae and Legionella spp. should be more widely used rather than reserved for cases not responding to standard therapy. Furthermore, realization that C. pneumoniae and Legionella spp. are common etiologies for community-acquired pneumonia should affect empiric antibiotic prescription.

@article{doi1010970000579219900900000004,
    author = "Fang, Guodong and Fine, Michael J. and Orloff, John J. and Arisumi, David and Yu, Victor L. and Kapoor, Wishwa N. and Grayston, J. Thomas and Wang, San Pin and Köhler, Richard and Muder, Robert R. and Yee, Ying C. and Rihs, John D. and Vickers, Richard M.",
    title = "New and Emerging Etiologies for Community-Acquired Pneumonia with Implications for Therapy",
    year = "1990",
    journal = "Medicine",
    abstract = "Three hundred fifty-nine consecutive patients with community-acquired pneumonia admitted to university, community, and VA hospitals underwent a standardized evaluation, including specialized tests for Legionella spp. and Chlamydia pneumoniae (TWAR). The most common underlying illnesses were immunosuppression (36.3\%), chronic obstructive pulmonary disease (32.4\%), and malignancy (28.4\%). The most frequent etiologic agents were Streptococcus pneumoniae (15.3\%) and Hemophilus influenzae (10.9\%). Surprisingly, Legionella spp. and C. pneumoniae were the third and fourth most frequent etiologies at 6.7\% and 6.1\%, respectively. Aerobic gram-negative pneumonias were relatively uncommon causes of pneumonia despite the fact that empiric broad-spectrum combination antibiotic therapy is so often directed at this subgroup. In 32.9\%, the etiology was undetermined. Antibiotic administration before admission was significantly associated with undetermined etiology (p = 0.0003). There were no distinctive clinical features found to be diagnostic for any etiologic agent, although high fever occurred more frequently in Legionnaires' disease. Clinical manifestations for C. pneumoniae were generally mild, although 38\% of patients had mental status changes. Mortality was highest for Staphylococcus aureus (50\%) and lowest for C. pneumoniae (4.5\%) and Mycoplasma pneumoniae (0\%). We document that specialized laboratory testing for C. pneumoniae and Legionella spp. should be more widely used rather than reserved for cases not responding to standard therapy. Furthermore, realization that C. pneumoniae and Legionella spp. are common etiologies for community-acquired pneumonia should affect empiric antibiotic prescription.",
    url = "https://doi.org/10.1097/00005792-199009000-00004",
    doi = "10.1097/00005792-199009000-00004",
    openalex = "W2040919444"
}

Orthologs and paralogs are two fundamentally different types of homologous genes that evolved, respectively, by vertical descent from a single ancestral gene and by duplication. Orthology and paralogy are key concepts of evolutionary genomics. A...Read More

@article{doi101146annurevge25120191000245,
    author = "Landman, Otto E.",
    title = "THE INHERITANCE OF ACQUIRED CHARACTERISTICS",
    year = "1991",
    journal = "Annual Review of Genetics",
    abstract = "Orthologs and paralogs are two fundamentally different types of homologous genes that evolved, respectively, by vertical descent from a single ancestral gene and by duplication. Orthology and paralogy are key concepts of evolutionary genomics. A...Read More",
    url = "https://doi.org/10.1146/annurev.ge.25.120191.000245",
    doi = "10.1146/annurev.ge.25.120191.000245",
    openalex = "W2173173565",
    references = "doi1010160092867482904627, doi1010160092867486902631, doi101038095550b0, doi101038scientificamerican017088, doi101073pnas437553, doi101073pnas532275, doi101086279202, doi101126science3310230, doi101128jb6445575691952, doi101146annurevbi38070169002343, openalexw2171582839"
}

Journal Article Guidelines for the Use of Systemic Glucocorticosteroids in the Management of Selected Infections Get access John E. McGowan, Jr., John E. McGowan, Jr. chairman Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar P. Joan Chesney, P. Joan Chesney Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar Kent B. Crossley, Kent B. Crossley Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar F. Marc LaForce F. Marc LaForce Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 165, Issue 1, January 1992, Pages 1–13, https://doi.org/10.1093/infdis/165.1.1 Published: 01 January 1992 Article history Received: 22 August 1991 Revision received: 13 September 1991 Published: 01 January 1992

@article{doi101093infdis16511,
    author = "McGowan, J. E. and Chesney, P. Joan and Crossley, Kent and LaForce, F. Marc",
    title = "Guidelines for the Use of Systemic Glucocorticosteroids in the Management of Selected Infections",
    year = "1992",
    journal = "The Journal of Infectious Diseases",
    abstract = "Journal Article Guidelines for the Use of Systemic Glucocorticosteroids in the Management of Selected Infections Get access John E. McGowan, Jr., John E. McGowan, Jr. chairman Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar P. Joan Chesney, P. Joan Chesney Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar Kent B. Crossley, Kent B. Crossley Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar F. Marc LaForce F. Marc LaForce Working Group on Steroid Use, Antimicrobial Agents Committee, Infectious Diseases Society of America Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 165, Issue 1, January 1992, Pages 1–13, https://doi.org/10.1093/infdis/165.1.1 Published: 01 January 1992 Article history Received: 22 August 1991 Revision received: 13 September 1991 Published: 01 January 1992",
    url = "https://doi.org/10.1093/infdis/165.1.1",
    doi = "10.1093/infdis/165.1.1",
    openalex = "W2069431357"
}

@article{doi101038364712a0,
    author = "Clark, Mertice M. and Karpiuk, Peter and Galef, Bennett G.",
    title = "Hormonally mediated inheritance of acquired characteristics in Mongolian gerbils",
    year = "1993",
    journal = "Nature",
    url = "https://doi.org/10.1038/364712a0",
    doi = "10.1038/364712a0",
    openalex = "W1983667605",
    references = "doi1010079781468430691, doi1010160018506x78900235, doi101016003193849290447a, doi101038266722a0, doi101095biolreprod194842, doi101126science6857252, doi101126science7244634, doi101126science7367881, doi101530jrf00960709, doi102527jas19896771824x"
}

Between September 1, 1981, and August 31, 1982, all patients with suspected or confirmed pneumonia among the 46,979 inhabitants of four municipalities in the province of Kuopio, Finland, were reported to a pneumonia register by their attending physicians. In addition, two study pathologists reported all cases of pneumonia found at autopsy, and two permanent registers were checked for retrospective identification of patients. Chest radiographs were obtained from 97% of all patients. The final diagnosis was based on radiologic or autopsy criteria. A total 546 patients (323 males and 223 females) had community-acquired pneumonia; of these, 37% were less than 15 years of age, and 31% were 60 years of age or older. Nineteen percent of the patients had defined chronic conditions, and 42% were admitted to hospital. The case fatality rate was 4%. The overall incidence of community-acquired pneumonia per 1,000 inhabitants per year was 11.6 (13.9 in males, 9.4 in females). The age-specific incidence per 1,000 inhabitants per year was as follows: age or = 75 years, 34.2.

@article{doi101093oxfordjournalsajea116770,
    author = "Jokinen, C and Heiskanen, Leena and Juvonen, H. and Kallinen, S. and Karkola, Kari and Korppi, Matti and KURKI, SEIJA and Rönnberg, P—R. and Seppä, Anders and Soimakallio, S. and Stén, Marja and Tanska, S and Tarkiainen, A. and Tukiainen, H and Pyörälà, Kalevi and Mäkelä, P. Helena",
    title = "Incidence of Community-Acquired Pneumonia in the Population of Four Municipalities in Eastern Finland",
    year = "1993",
    journal = "American Journal of Epidemiology",
    abstract = "Between September 1, 1981, and August 31, 1982, all patients with suspected or confirmed pneumonia among the 46,979 inhabitants of four municipalities in the province of Kuopio, Finland, were reported to a pneumonia register by their attending physicians. In addition, two study pathologists reported all cases of pneumonia found at autopsy, and two permanent registers were checked for retrospective identification of patients. Chest radiographs were obtained from 97\% of all patients. The final diagnosis was based on radiologic or autopsy criteria. A total 546 patients (323 males and 223 females) had community-acquired pneumonia; of these, 37\% were less than 15 years of age, and 31\% were 60 years of age or older. Nineteen percent of the patients had defined chronic conditions, and 42\% were admitted to hospital. The case fatality rate was 4\%. The overall incidence of community-acquired pneumonia per 1,000 inhabitants per year was 11.6 (13.9 in males, 9.4 in females). The age-specific incidence per 1,000 inhabitants per year was as follows: age or = 75 years, 34.2.",
    url = "https://doi.org/10.1093/oxfordjournals.aje.a116770",
    doi = "10.1093/oxfordjournals.aje.a116770",
    openalex = "W1960495543"
}

"Medical Section pf the American Lung Association: Guidelines for the Initial Management of Adults with Community-acquired Pneumonia: Diagnosis, Assessment of Severity, and Initial Antimicrobial Therapy." American Review of Respiratory Disease, 148(5), pp. 1418–1426

@article{doi101164ajrccm14851418,
    author = "Niederman, Michael S. and Bass, John B. and Campbell, G. Douglas and Fein, Alan M. and Grossman, Ronald F. and Mandell, Lionel A. and Marrie, Thomas J. and Sarosi, George A. and Torres, Antoní and Yu, Victor L.",
    title = "Medical Section pf the American Lung Association: Guidelines for the Initial Management of Adults with Community-acquired Pneumonia: Diagnosis, Assessment of Severity, and Initial Antimicrobial Therapy",
    year = "1993",
    journal = "American Review of Respiratory Disease",
    abstract = {"Medical Section pf the American Lung Association: Guidelines for the Initial Management of Adults with Community-acquired Pneumonia: Diagnosis, Assessment of Severity, and Initial Antimicrobial Therapy." American Review of Respiratory Disease, 148(5), pp. 1418–1426},
    url = "https://doi.org/10.1164/ajrccm/148.5.1418",
    doi = "10.1164/ajrccm/148.5.1418",
    openalex = "W2027162482"
}

@article{openalexw3146425871,
    author = "Niederman",
    title = "Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. American Thoracic Society. Medical Section of the American Lung Association",
    year = "1993",
    journal = "Medical Entomology and Zoology",
    openalex = "W3146425871"
}

Journal Article Community-Acquired Pneumonia Get access Thomas J. Marrie Thomas J. Marrie From the Departments of Medicine and Microbiology, Dalhousie University, and Victoria General Hospital, Halifax, Nova Scotia, Canada Reprints or correspondence: Dr. T. J. Marrie, Room 5014 ACC, 1278 Tower Road, Halifax, Nova Scotia B3H 2Y9, Canada. Search for other works by this author on: Oxford Academic PubMed Google Scholar Clinical Infectious Diseases, Volume 18, Issue 4, April 1994, Pages 501–515, https://doi.org/10.1093/clinids/18.4.501 Published: 01 April 1994 Article history Received: 19 November 1993 Published: 01 April 1994

@article{doi101093clinids184501,
    author = "Marrie, Thomas J.",
    title = "Community-Acquired Pneumonia",
    year = "1994",
    journal = "Clinical Infectious Diseases",
    abstract = "Journal Article Community-Acquired Pneumonia Get access Thomas J. Marrie Thomas J. Marrie From the Departments of Medicine and Microbiology, Dalhousie University, and Victoria General Hospital, Halifax, Nova Scotia, Canada Reprints or correspondence: Dr. T. J. Marrie, Room 5014 ACC, 1278 Tower Road, Halifax, Nova Scotia B3H 2Y9, Canada. Search for other works by this author on: Oxford Academic PubMed Google Scholar Clinical Infectious Diseases, Volume 18, Issue 4, April 1994, Pages 501–515, https://doi.org/10.1093/clinids/18.4.501 Published: 01 April 1994 Article history Received: 19 November 1993 Published: 01 April 1994",
    url = "https://doi.org/10.1093/clinids/18.4.501",
    doi = "10.1093/clinids/18.4.501",
    openalex = "W2083733667"
}

Pneumonia has been recognized as a common and potentially lethal condition for nearly two centuries. Comprehensive studies of the disease in the pre-antibiotic era showed mortality rates of about 1 per 1000 per year; over 80 percent of the cases were due to Streptococcus pneumoniae, and mortality rates were generally reported at 20 to 40 percent.1,2 Community-acquired pneumonia (as distinguished from that acquired nosocomially or in a nursing home) continues to be a common and serious illness. Current estimates for the United States are 4 million cases annually, an attack rate of 12 per 1000 adults per year, about...

@article{doi101056nejm199512143332408,
    author = "Bartlett, John G. and Mundy, Linda M.",
    title = "Community-Acquired Pneumonia",
    year = "1995",
    journal = "New England Journal of Medicine",
    abstract = "Pneumonia has been recognized as a common and potentially lethal condition for nearly two centuries. Comprehensive studies of the disease in the pre-antibiotic era showed mortality rates of about 1 per 1000 per year; over 80 percent of the cases were due to Streptococcus pneumoniae, and mortality rates were generally reported at 20 to 40 percent.1,2 Community-acquired pneumonia (as distinguished from that acquired nosocomially or in a nursing home) continues to be a common and serious illness. Current estimates for the United States are 4 million cases annually, an attack rate of 12 per 1000 adults per year, about...",
    url = "https://doi.org/10.1056/nejm199512143332408",
    doi = "10.1056/nejm199512143332408",
    openalex = "W3143755808",
    references = "doi1010160002934385903614, doi101056nejm199508243330802, doi101056nejm199508243330803, doi101093clinids114586, doi101093clinids184501, doi101093oxfordjournalsqjmeda068093, doi1010970000579219900900000004, doi101164ajrccm1422481, doi101164ajrccm14851418, openalexw3146425871"
}

We evaluated 260 previously healthy children ages 3 through 12 years who had clinical signs and symptoms of pneumonia, radiographically confirmed. Patients were randomized 1:1 to a 10-day course of either clarithromycin suspension 15 mg/kg/day divided twice a day or erythromycin suspension 40 mg/kg/day divided twice a day or three times a day. Evidence of infection with Chlamydia pneumoniae was detected in 28% (74) of patients: 13% (34) by nasopharyngeal culture and 18% (48) by serology with the microimmunofluorescence assay. Evidence of infection with Mycoplasma pneumoniae was detected in 27% (69) of patients: 20% (53) by nasopharyngeal culture or polymerase chain reaction and 17% (44) by serology with the use of enzyme-linked immunosorbent assay. Serologic confirmation of infection was observed in 23% (8) and 53% (28) of patients with bacteriologically detected C. pneumoniae and M. pneumoniae, respectively. Treatment with clarithromycin vs. erythromycin, respectively, yielded the following outcomes: clinical success 98% (121 of 124) vs. 95% (105 of 110); radiologic success 98% (109 of 111) vs. 94% (92 of 110); and eradication by pathogen, C. pneumoniae 79% (15 of 19) vs. 86% (12 of 14) and M. pneumoniae 100% (9 of 9) vs. 100% (4 of 4). Adverse events were primarily gastrointestinal occurring in almost one-fourth of patients in both groups, and were mild to moderate in severity. Clarithromycin and erythromycin were similarly effective and safe for the treatment of radiographically proved, community-acquired pneumonia in children older than 2 years old.(ABSTRACT TRUNCATED AT 250 WORDS)

@article{doi1010970000645419950600000002,
    author = "Block, Stan and Hedrick, James and Hammerschlag, Margaret R. and Cassell, Gail H. and Craft, J. Carl",
    title = "Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia",
    year = "1995",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "We evaluated 260 previously healthy children ages 3 through 12 years who had clinical signs and symptoms of pneumonia, radiographically confirmed. Patients were randomized 1:1 to a 10-day course of either clarithromycin suspension 15 mg/kg/day divided twice a day or erythromycin suspension 40 mg/kg/day divided twice a day or three times a day. Evidence of infection with Chlamydia pneumoniae was detected in 28\% (74) of patients: 13\% (34) by nasopharyngeal culture and 18\% (48) by serology with the microimmunofluorescence assay. Evidence of infection with Mycoplasma pneumoniae was detected in 27\% (69) of patients: 20\% (53) by nasopharyngeal culture or polymerase chain reaction and 17\% (44) by serology with the use of enzyme-linked immunosorbent assay. Serologic confirmation of infection was observed in 23\% (8) and 53\% (28) of patients with bacteriologically detected C. pneumoniae and M. pneumoniae, respectively. Treatment with clarithromycin vs. erythromycin, respectively, yielded the following outcomes: clinical success 98\% (121 of 124) vs. 95\% (105 of 110); radiologic success 98\% (109 of 111) vs. 94\% (92 of 110); and eradication by pathogen, C. pneumoniae 79\% (15 of 19) vs. 86\% (12 of 14) and M. pneumoniae 100\% (9 of 9) vs. 100\% (4 of 4). Adverse events were primarily gastrointestinal occurring in almost one-fourth of patients in both groups, and were mild to moderate in severity. Clarithromycin and erythromycin were similarly effective and safe for the treatment of radiographically proved, community-acquired pneumonia in children older than 2 years old.(ABSTRACT TRUNCATED AT 250 WORDS)",
    url = "https://doi.org/10.1097/00006454-199506000-00002",
    doi = "10.1097/00006454-199506000-00002",
    openalex = "W2010662001"
}

Mortality for patients hospitalized with CAP was high and was associated with characteristics of the study cohort, pneumonia etiology, and a variety of prognostic factors. Generalization of these findings to all patients with CAP should be made with caution because of insufficient published information on medical outcomes other than mortality in ambulatory patients.

@article{doi101001jama199603530260048030,
    author = "Fine, Michael J.",
    title = "Prognosis and Outcomes of Patients With Community-Acquired Pneumonia",
    year = "1996",
    journal = "JAMA",
    abstract = "Mortality for patients hospitalized with CAP was high and was associated with characteristics of the study cohort, pneumonia etiology, and a variety of prognostic factors. Generalization of these findings to all patients with CAP should be made with caution because of insufficient published information on medical outcomes other than mortality in ambulatory patients.",
    url = "https://doi.org/10.1001/jama.1996.03530260048030",
    doi = "10.1001/jama.1996.03530260048030",
    openalex = "W2037712857"
}

Measures of salivary testosterone and the personality dimensions of aggression and pro-social behavior were obtained in 306 (155 male and 151 female) university students. Each participant provided two samples of saliva and completed ten self-report personality scales from multiple inventories. A factor analysis of the personality scales produced two factors, an aggression factor and a pro-social behavior factor. Men averaged five times the amount of salivary testosterone as women (99 pg/ml vs. 18.5 pg/ml) and rated themselves as more aggressive and less nurturant. Within each sex, testosterone was positively correlated with aggression and negatively correlated with pro-social personality. Structural equation modelling analyses suggested that a direct effect model best described the relationship between salivary testosterone and the latent personality dimensions of aggression and pro-social behavior. © 1996 Wiley-Liss, Inc.

@article{doi101002sici109823371996225321aidab130co2m,
    author = "Harris, Julie Aitken and Rushton, J. Philippe and Hampson, Elizabeth and Jackson, Douglas N.",
    title = "Salivary testosterone and self-report aggressive and pro-social personality characteristics in men and women",
    year = "1996",
    journal = "Aggressive Behavior",
    abstract = "Measures of salivary testosterone and the personality dimensions of aggression and pro-social behavior were obtained in 306 (155 male and 151 female) university students. Each participant provided two samples of saliva and completed ten self-report personality scales from multiple inventories. A factor analysis of the personality scales produced two factors, an aggression factor and a pro-social behavior factor. Men averaged five times the amount of salivary testosterone as women (99 pg/ml vs. 18.5 pg/ml) and rated themselves as more aggressive and less nurturant. Within each sex, testosterone was positively correlated with aggression and negatively correlated with pro-social personality. Structural equation modelling analyses suggested that a direct effect model best described the relationship between salivary testosterone and the latent personality dimensions of aggression and pro-social behavior. © 1996 Wiley-Liss, Inc.",
    url = "https://doi.org/10.1002/(sici)1098-2337(1996)22:5<321::aid-ab1>3.0.co;2-m",
    doi = "10.1002/(sici)1098-2337(1996)22:5<321::aid-ab1>3.0.co;2-m",
    openalex = "W2119297581"
}

These data provide information about the importance of community-acquired pneumonia and the relative and overall impact of specific causes of pneumonia. The study provides a basis for choosing optimal empiric pneumonia therapy, and allows interventions for prevention of pneumonia to be targeted at groups at greatest risk for serious illness and death.

@article{doi101001archinte199700440360129015,
    author = "Marston, Barbara J.",
    title = "Incidence of Community-Acquired Pneumonia Requiring Hospitalization",
    year = "1997",
    journal = "Archives of Internal Medicine",
    abstract = "These data provide information about the importance of community-acquired pneumonia and the relative and overall impact of specific causes of pneumonia. The study provides a basis for choosing optimal empiric pneumonia therapy, and allows interventions for prevention of pneumonia to be targeted at groups at greatest risk for serious illness and death.",
    url = "https://doi.org/10.1001/archinte.1997.00440360129015",
    doi = "10.1001/archinte.1997.00440360129015",
    openalex = "W1965015119",
    references = "doi101056nejm199512143332408"
}

The prediction rule we describe accurately identifies the patients with community-acquired pneumonia who are at low risk for death and other adverse outcomes. This prediction rule may help physicians make more rational decisions about hospitalization for patients with pneumonia.

@article{doi101056nejm199701233360402,
    author = "Fine, Michael J. and Auble, Thomas E. and Yealy, Donald M. and Hanusa, Barbara H. and Weissfeld, Lisa A. and Singer, Daniel E. and Coley, Christopher M. and Marrie, Thomas J. and Kapoor, Wishwa N.",
    title = "A Prediction Rule to Identify Low-Risk Patients with Community-Acquired Pneumonia",
    year = "1997",
    journal = "New England Journal of Medicine",
    abstract = "The prediction rule we describe accurately identifies the patients with community-acquired pneumonia who are at low risk for death and other adverse outcomes. This prediction rule may help physicians make more rational decisions about hospitalization for patients with pneumonia.",
    url = "https://doi.org/10.1056/nejm199701233360402",
    doi = "10.1056/nejm199701233360402",
    openalex = "W2320270386",
    references = "doi101056nejm199512143332408"
}

@article{bartlett1998communityacquired,
    author = "Bartlett, John G. and Breiman, Robert F. and Mandell, Lionel A. and File, Jr., Thomas M.",
    title = "Community‐Acquired Pneumonia in Adults: Guidelines for Management",
    year = "1998",
    journal = "Clinical Infectious Diseases",
    url = "https://doi.org/10.1086/513953",
    doi = "10.1086/513953",
    number = "4",
    openalex = "W2112302527",
    pages = "811-838",
    volume = "26",
    references = "doi1010160002934394900604, doi1010160021968184901498, doi101056nejm199512143332408, doi101093clinids16supplement4s248, doi101093clinids183421, doi101093clinids193387, doi101093clinids234671, doi101093infdis17511, openalexw2342068279, openalexw3140139051"
}

@article{crossref1998guidelines,
    title = "Guidelines for the management of community-acquired pneumonia",
    year = "1998",
    journal = "PharmacoEconomics \& Outcomes News",
    url = "https://doi.org/10.1007/bf03277560",
    doi = "10.1007/bf03277560",
    number = "1",
    openalex = "W2462338698",
    pages = "5-5",
    volume = "161",
    references = "doi101001jama199703550230056037, doi101086313954"
}

These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.

@article{doi101001jama2798593,
    author = "Herold, Betsy C.",
    title = "Community-Acquired Methicillin-Resistant Staphylococcus aureus in Children With No Identified Predisposing Risk",
    year = "1998",
    journal = "JAMA",
    abstract = "These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.",
    url = "https://doi.org/10.1001/jama.279.8.593",
    doi = "10.1001/jama.279.8.593",
    openalex = "W2097879657"
}

We compared high-resolution computed tomography (HRCT) with chest radiography (CR) to determine if there is any advantage to using HRCT in the diagnosis of community-acquired pneumonia (CAP). Simultaneously obtained chest radiographs were compared with HRCT scans for 47 patients with clinical symptoms and signs suspicious for CAP, HRCT identified all 18 CAP cases (38.3%) apparent on radiographs as well as eight additional cases (i.e., 55.3%); P =.004. The corresponding figures for bilateral involvement were six by CR (33.3%) and 16 by HRCT (61.5%), P =.001. CR did not show changes particularly affecting the upper and lower lung lobes and the lingula. Bronchopneumonia was visualized by CR in 11 cases (61.1%) and by HRCT in 22 cases (84.6%). The corresponding figures for airspace pneumonia were four (22.2%) and one (3.8%), respectively. The use of HRCT seems to increase the number of CAP cases confirmed by imaging and to improve the accuracy of diagnosing and typing of CAP.

@article{doi101086514675,
    author = "Syrjälä, Hannu and Broas, Markku and Suramo, I. and Ojala, Airi and Lähde, S",
    title = "High‐Resolution Computed Tomography for the Diagnosis of Community‐Acquired Pneumonia",
    year = "1998",
    journal = "Clinical Infectious Diseases",
    abstract = "We compared high-resolution computed tomography (HRCT) with chest radiography (CR) to determine if there is any advantage to using HRCT in the diagnosis of community-acquired pneumonia (CAP). Simultaneously obtained chest radiographs were compared with HRCT scans for 47 patients with clinical symptoms and signs suspicious for CAP, HRCT identified all 18 CAP cases (38.3\%) apparent on radiographs as well as eight additional cases (i.e., 55.3\%); P =.004. The corresponding figures for bilateral involvement were six by CR (33.3\%) and 16 by HRCT (61.5\%), P =.001. CR did not show changes particularly affecting the upper and lower lung lobes and the lingula. Bronchopneumonia was visualized by CR in 11 cases (61.1\%) and by HRCT in 22 cases (84.6\%). The corresponding figures for airspace pneumonia were four (22.2\%) and one (3.8\%), respectively. The use of HRCT seems to increase the number of CAP cases confirmed by imaging and to improve the accuracy of diagnosing and typing of CAP.",
    url = "https://doi.org/10.1086/514675",
    doi = "10.1086/514675",
    openalex = "W2030416073",
    references = "doi1010160021968184901498"
}

Azithromycin used once daily for 5 days produced a satisfactory therapeutic outcome similar to those of amoxicillin/clavulanate or erythromycin given three times a day for 10 days for treatment of community-acquired pneumonia. Azithromycin had significantly fewer side effects than comparator drugs.

@article{doi1010970000645419981000000004,
    author = "Harris, Jo-Ann and Kolokathis, Antonia and Campbell, M. and Cassell, Gail H. and Hammerschlag, Margaret R.",
    title = "Safety and efficacy of azithromycin in the treatment of community-acquired pneumonia in children",
    year = "1998",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "Azithromycin used once daily for 5 days produced a satisfactory therapeutic outcome similar to those of amoxicillin/clavulanate or erythromycin given three times a day for 10 days for treatment of community-acquired pneumonia. Azithromycin had significantly fewer side effects than comparator drugs.",
    url = "https://doi.org/10.1097/00006454-199810000-00004",
    doi = "10.1097/00006454-199810000-00004",
    openalex = "W2001166659"
}

The results of our prospective, strictly population-based study confirm the importance of S. pneumoniae in the etiology of community-acquired pneumonia in children of all ages. M. pneumoniae and Chlamydia pneumoniae are important from the age of 5 years onwards.

@article{doi1010970000645419981100000004,
    author = "Heiskanen‐Kosma, Tarja and Korppi, Matti and Jokinen, C and KURKI, SEIJA and Heiskanen, Leena and Juvonen, H. and Kallinen, S. and Stén, Marja and Tarkiainen, A. and Rönnberg, Pirjo-Riitta and Kleemola, Marjaana and Mäkelä, P. Helena and Leinonen, Maija",
    title = "Etiology of childhood pneumonia: serologic results of a prospective, population-based study",
    year = "1998",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "The results of our prospective, strictly population-based study confirm the importance of S. pneumoniae in the etiology of community-acquired pneumonia in children of all ages. M. pneumoniae and Chlamydia pneumoniae are important from the age of 5 years onwards.",
    url = "https://doi.org/10.1097/00006454-199811000-00004",
    doi = "10.1097/00006454-199811000-00004",
    openalex = "W2005883387"
}

@article{na1998guidelines,
    author = "\\\&NA;",
    title = "Guidelines for the management of community-acquired pneumonia",
    year = "1998",
    journal = "Inpharma Weekly",
    url = "https://doi.org/10.2165/00128413-199811360-00007",
    doi = "10.2165/00128413-199811360-00007",
    number = "1136",
    openalex = "W4249825987",
    pages = "5",
    volume = "\&NA;"
}

@article{openalexw3004715361,
    author = "Huchon, G",
    title = "Management of adult community-acquired lower respiratory tract infections",
    year = "1998",
    journal = "European Respiratory Review",
    openalex = "W3004715361"
}

Although a possible microbial etiology was identified in 43% of the evaluable patients, clinical findings and results of blood cultures, chest radiographs and white blood cell and differential counts did not distinguish patients with a defined etiology from those without a known cause for pneumonia. There were no differences in the clinical responses of patients to the antimicrobial regimens studied.

@article{doi1010970000645419990200000004,
    author = "Wubbel, Loretta and Muniz, Luz Stella and Ahmed, Amina and Trujillo, Mónica and Carubelli, Cecilia M and McCoig, Cynthia and Abramo, Tom and Leinonen, Maija and McCracken, George H.",
    title = "Etiology and treatment of community-acquired pneumonia in ambulatory children",
    year = "1999",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "Although a possible microbial etiology was identified in 43\% of the evaluable patients, clinical findings and results of blood cultures, chest radiographs and white blood cell and differential counts did not distinguish patients with a defined etiology from those without a known cause for pneumonia. There were no differences in the clinical responses of patients to the antimicrobial regimens studied.",
    url = "https://doi.org/10.1097/00006454-199902000-00004",
    doi = "10.1097/00006454-199902000-00004",
    openalex = "W2075612635"
}

The aim of the study was to determine risk factors for severe community-acquired pneumonia (CAP) as well as to compare microbial patterns of severe CAP to a previous study from our respiratory intensive care unit (ICU) originating from 1984 to 1987. Patients admitted to the ICU according to clinical judgment were defined as having severe CAP. For the study of risk factors, a hospital-based case-control design was used, matching each patient with severe CAP to a patient hospitalized with CAP but not requiring ICU admission. Microbial investigation included noninvasive and invasive techniques. Overall, 89 patients with severe CAP were successfully matched to a control patient. The presence of an alcohol ingestion of >/= 80 g/d (odds ratio [OR] 3.9, 95% confidence interval [CI] 1.4 to 10.6, p = 0.008) was found to be an independent risk factor for severe CAP and prior ambulatory antimicrobial treatment (OR 0.37, 95% CI 0.17 to 0.79, p = 0.009) to be protective. Streptococcus pneumoniae (24%) continued to be the most frequent pathogen; however, 48% of strains were drug-resistant. "Atypical" bacterial pathogens were significantly more common (17% versus 6%, p = 0.006) and Legionella spp. less common (2% versus 14%, p = 0.004) than in our previous study, whereas gram-negative enteric bacilli (GNEB) and Pseudomonas aeruginosa continued to represent important pathogens (6% and 5%, respectively). Our findings provide additional evidence for the importance of the initiation of early empiric antimicrobial treatment for a favorable outcome of CAP. Variations of microbial patterns are only in part due to different epidemiological settings. Therefore, initial empiric antimicrobial treatment will also have to take into account local trends of changing microbial patterns.

@article{doi101164ajrccm16039901107,
    author = "Ruiz, Mauricio and Ewig, Santiago and Torres, Antoni and Arancibia, Francisco and Marco, Francesc and Mensa, Josep and del Nogal Sánchez, Miguel and MARTINEZ, JOSE ANTONIO",
    title = "Severe Community-acquired Pneumonia: Risk Factors and Follow-up Epidemiology",
    year = "1999",
    journal = "American Journal of Respiratory and Critical Care Medicine",
    abstract = {The aim of the study was to determine risk factors for severe community-acquired pneumonia (CAP) as well as to compare microbial patterns of severe CAP to a previous study from our respiratory intensive care unit (ICU) originating from 1984 to 1987. Patients admitted to the ICU according to clinical judgment were defined as having severe CAP. For the study of risk factors, a hospital-based case-control design was used, matching each patient with severe CAP to a patient hospitalized with CAP but not requiring ICU admission. Microbial investigation included noninvasive and invasive techniques. Overall, 89 patients with severe CAP were successfully matched to a control patient. The presence of an alcohol ingestion of >/= 80 g/d (odds ratio [OR] 3.9, 95\% confidence interval [CI] 1.4 to 10.6, p = 0.008) was found to be an independent risk factor for severe CAP and prior ambulatory antimicrobial treatment (OR 0.37, 95\% CI 0.17 to 0.79, p = 0.009) to be protective. Streptococcus pneumoniae (24\%) continued to be the most frequent pathogen; however, 48\% of strains were drug-resistant. "Atypical" bacterial pathogens were significantly more common (17\% versus 6\%, p = 0.006) and Legionella spp. less common (2\% versus 14\%, p = 0.004) than in our previous study, whereas gram-negative enteric bacilli (GNEB) and Pseudomonas aeruginosa continued to represent important pathogens (6\% and 5\%, respectively). Our findings provide additional evidence for the importance of the initiation of early empiric antimicrobial treatment for a favorable outcome of CAP. Variations of microbial patterns are only in part due to different epidemiological settings. Therefore, initial empiric antimicrobial treatment will also have to take into account local trends of changing microbial patterns.},
    url = "https://doi.org/10.1164/ajrccm.160.3.9901107",
    doi = "10.1164/ajrccm.160.3.9901107",
    openalex = "W2121756063",
    references = "doi1010160002934394900604"
}

When implicated in cases of pneumonia, S pneumoniae should be considered susceptible if penicillin minimum inhibitory concentration (MIC) is no greater than 1 microg/mL, of intermediate susceptibility if MIC is 2 microg/ mL, and resistant if MIC is no less than 4 microg/mL. For outpatient treatment of community-acquired pneumonia, suitable empirical oral antimicrobial agents include a macrolide (eg, erythromycin, clarithromycin, azithromycin), doxycycline (or tetracycline) for children aged 8 years or older, or an oral beta-lactam with good activity against pneumococci (eg, cefuroxime axetil, amoxicillin, or a combination of amoxicillin and clavulanate potassium). Suitable empirical antimicrobial regimens for inpatient pneumonia include an intravenous beta-lactam, such as cefuroxime, ceftriaxone sodium, cefotaxime sodium, or a combination of ampicillin sodium and sulbactam sodium plus a macrolide. New fluoroquinolones with improved activity against S pneumoniae can also be used to treat adults with community-acquired pneumonia. To limit the emergence of fluoroquinolone-resistant strains, the new fluoroquinolones should be limited to adults (1) for whom one of the above regimens has already failed, (2) who are allergic to alternative agents, or (3) who have a documented infection with highly drug-resistant pneumococci (eg, penicillin MIC > or =4 microg/mL). Vancomycin hydrochloride is not routinely indicated for the treatment of community-acquired pneumonia or pneumonia caused by DRSP.

@article{doi101001archinte160101399,
    author = "Heffelfinger, James D.",
    title = "Management of Community-Acquired Pneumonia in the Era of Pneumococcal Resistance",
    year = "2000",
    journal = "Archives of Internal Medicine",
    abstract = "When implicated in cases of pneumonia, S pneumoniae should be considered susceptible if penicillin minimum inhibitory concentration (MIC) is no greater than 1 microg/mL, of intermediate susceptibility if MIC is 2 microg/ mL, and resistant if MIC is no less than 4 microg/mL. For outpatient treatment of community-acquired pneumonia, suitable empirical oral antimicrobial agents include a macrolide (eg, erythromycin, clarithromycin, azithromycin), doxycycline (or tetracycline) for children aged 8 years or older, or an oral beta-lactam with good activity against pneumococci (eg, cefuroxime axetil, amoxicillin, or a combination of amoxicillin and clavulanate potassium). Suitable empirical antimicrobial regimens for inpatient pneumonia include an intravenous beta-lactam, such as cefuroxime, ceftriaxone sodium, cefotaxime sodium, or a combination of ampicillin sodium and sulbactam sodium plus a macrolide. New fluoroquinolones with improved activity against S pneumoniae can also be used to treat adults with community-acquired pneumonia. To limit the emergence of fluoroquinolone-resistant strains, the new fluoroquinolones should be limited to adults (1) for whom one of the above regimens has already failed, (2) who are allergic to alternative agents, or (3) who have a documented infection with highly drug-resistant pneumococci (eg, penicillin MIC > or =4 microg/mL). Vancomycin hydrochloride is not routinely indicated for the treatment of community-acquired pneumonia or pneumonia caused by DRSP.",
    url = "https://doi.org/10.1001/archinte.160.10.1399",
    doi = "10.1001/archinte.160.10.1399",
    openalex = "W1986505505"
}

In this study, implementation of a critical pathway reduced the use of institutional resources without causing adverse effects on the well-being of patients.

@article{doi101001jama2836749,
    author = "Marrie, Thomas J.",
    title = "A Controlled Trial of a Critical Pathway for Treatment of Community-Acquired Pneumonia",
    year = "2000",
    journal = "JAMA",
    abstract = "In this study, implementation of a critical pathway reduced the use of institutional resources without causing adverse effects on the well-being of patients.",
    url = "https://doi.org/10.1001/jama.283.6.749",
    doi = "10.1001/jama.283.6.749",
    openalex = "W2132950564"
}

An outbreak of severe pneumococcal pneumonia among children occurred in Iowa from November 1995 through January 1996. An associated outbreak of influenza disease was predominantly caused by influenza A (H1N1) for the first time since 1989. We conducted a case-control study to determine whether preceding influenza infection was directly associated with pneumococcal illness. We identified 13 children with severe pneumococcal pneumonia. Patients were more likely than control subjects to report experiencing an influenza-like illness in the 7-28 days preceding admission (matched odds ratio [OR], 12.4; 95% confidence interval [CI], 1.7-306). Likewise, family members of patients were more likely than those of control subjects to report experiencing an influenza-like illness in the 28 days preceding their admission date (OR, 2.6; 95% CI, 1.0-6. 3). Patients were more likely than control subjects to have a positive influenza A (H1N1) convalescent serology (matched OR, 3.7; 95% CI, 1.0-18.1). This study provides direct and indirect evidence that influenza infection led to severe pneumococcal pneumonia among these children. Prevention of pneumococcal disease should be included among the potential benefits of influenza vaccination.

@article{doi101086313772,
    author = "O’Brien, Katherine L. and Walters, Melanie and Sellman, Jonathan and Quinlisk, Patricia and Regnery, Helen L. and Schwartz, Benjamin and Dowell, Scott F.",
    title = "Severe Pneumococcal Pneumonia in Previously Healthy Children: The Role of Preceding Influenza Infection",
    year = "2000",
    journal = "Clinical Infectious Diseases",
    abstract = "An outbreak of severe pneumococcal pneumonia among children occurred in Iowa from November 1995 through January 1996. An associated outbreak of influenza disease was predominantly caused by influenza A (H1N1) for the first time since 1989. We conducted a case-control study to determine whether preceding influenza infection was directly associated with pneumococcal illness. We identified 13 children with severe pneumococcal pneumonia. Patients were more likely than control subjects to report experiencing an influenza-like illness in the 7-28 days preceding admission (matched odds ratio [OR], 12.4; 95\% confidence interval [CI], 1.7-306). Likewise, family members of patients were more likely than those of control subjects to report experiencing an influenza-like illness in the 28 days preceding their admission date (OR, 2.6; 95\% CI, 1.0-6. 3). Patients were more likely than control subjects to have a positive influenza A (H1N1) convalescent serology (matched OR, 3.7; 95\% CI, 1.0-18.1). This study provides direct and indirect evidence that influenza infection led to severe pneumococcal pneumonia among these children. Prevention of pneumococcal disease should be included among the potential benefits of influenza vaccination.",
    url = "https://doi.org/10.1086/313772",
    doi = "10.1086/313772",
    openalex = "W2106336605"
}

John G. Bartlett,1 Scott F Dowell,2 Lionel A. Mandell,6 Thomas M. File, Jr.,3 Daniel M. Musher,4 and Michael J. Fine5 'Johns Hopkins University School of Medicine, Baltimore, Maryland, 2Centers for Disease Control and Prevention, Atlanta, Georgia, 3Northeastern Ohio Universities College of Medicine, Cleveland, Ohio, 4Baylor College of Medicine and Veterans Affairs Medical Center, Houston, Texas, and 5University of Pittsburgh, Pennsylvania, USA; and 6McMaster University, Toronto, Canada

@article{doi101086313954,
    author = "Bartlett, John G. and Dowell, Scott F. and Mandell, Lionel A. and File, Thomas M. and Musher, Daniel M. and Fine, Michael J.",
    title = "Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults",
    year = "2000",
    journal = "Clinical Infectious Diseases",
    abstract = "John G. Bartlett,1 Scott F Dowell,2 Lionel A. Mandell,6 Thomas M. File, Jr.,3 Daniel M. Musher,4 and Michael J. Fine5 'Johns Hopkins University School of Medicine, Baltimore, Maryland, 2Centers for Disease Control and Prevention, Atlanta, Georgia, 3Northeastern Ohio Universities College of Medicine, Cleveland, Ohio, 4Baylor College of Medicine and Veterans Affairs Medical Center, Houston, Texas, and 5University of Pittsburgh, Pennsylvania, USA; and 6McMaster University, Toronto, Canada",
    url = "https://doi.org/10.1086/313954",
    doi = "10.1086/313954",
    openalex = "W2130141864",
    references = "bartlett1998communityacquired, doi101001jama199603530260048030, doi101001jama281222127, doi1010160002934394900604, doi1010160021968184901498, doi101016c20121000756, doi101056nejm199111213252101, doi101056nejm199512143332408, doi101056nejm199701233360402, doi101056nejm199907223410403, doi101093clinids16supplement4s248, doi101093clinids183421, doi101093clinids193387, doi101093clinids234671, doi101093infdis1193317, doi101093infdis17511, doi1073260003481911498185, doi10732600034819123719951001000008, openalexw2342068279, openalexw2915657181, openalexw3140139051"
}

Lionel A Mandell MD FRCPC1, Thomas J Marrie MD FRCPC2, Ronald F Grossman MD FRCPC FACP3, Anthony W Chow MD FRCPC FACP4, Robert H Hyland MD FRCPC5, and the Canadian CAP Working Group* McMaster University, Hamilton, Ontario; Dalhousie University, Halifax, Nova Scotia; QEII Health Sciences Centre, Halifax, Nova Scotia; University of British Columbia, Vancouver, British Columbia; St Michael’s Hospital, Toronto, Ontario

@article{doi101086313959,
    author = "Mandell, Lionel A. and Marrie, Thomas J. and Grossman, Ronald F. and Chow, Anthony W. and Hyland, Robert H. and and the Canadian Community-Acquired Pneumonia Working Group",
    title = "Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia: An Evidence-Based Update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society",
    year = "2000",
    journal = "Clinical Infectious Diseases",
    abstract = "Lionel A Mandell MD FRCPC1, Thomas J Marrie MD FRCPC2, Ronald F Grossman MD FRCPC FACP3, Anthony W Chow MD FRCPC FACP4, Robert H Hyland MD FRCPC5, and the Canadian CAP Working Group* McMaster University, Hamilton, Ontario; Dalhousie University, Halifax, Nova Scotia; QEII Health Sciences Centre, Halifax, Nova Scotia; University of British Columbia, Vancouver, British Columbia; St Michael’s Hospital, Toronto, Ontario",
    url = "https://doi.org/10.1086/313959",
    doi = "10.1086/313959",
    openalex = "W2158075347",
    references = "bartlett1998communityacquired, doi101001archinte199700440360129015, doi101001jama199603530260048030, doi1010160002934394900604, doi1010160021968184901498, doi101056nejm199111213252101, doi101056nejm199409223311206, doi101056nejm199512143332408, doi101056nejm199701233360402, doi101056nejm199907223410403, doi101164ajrccm14851418, openalexw26641785, openalexw2915657181"
}

The possible causative agent of childhood community-acquired pneumonia can be detected in most cases. Further studies are warranted to determine what etiologic investigations would aid in the management of pneumonia. With effective immunization for S. pneumoniae and respiratory syncytial virus infections, more than one-half of the pneumonia cases in this study could have been prevented.

@article{doi1010970000645420000400000006,
    author = "Juvén, Taina and Mertsola, Jussi and Waris, Matti and Leinonen, Maija and Meurman, Olli and Roivainen, Merja and Eskola, J. and Saikku, Pekka and Ruuskanen, Olli",
    title = "Etiology of community-acquired pneumonia in 254 hospitalized children",
    year = "2000",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "The possible causative agent of childhood community-acquired pneumonia can be detected in most cases. Further studies are warranted to determine what etiologic investigations would aid in the management of pneumonia. With effective immunization for S. pneumoniae and respiratory syncytial virus infections, more than one-half of the pneumonia cases in this study could have been prevented.",
    url = "https://doi.org/10.1097/00006454-200004000-00006",
    doi = "10.1097/00006454-200004000-00006",
    openalex = "W2029647933",
    references = "doi101016s0140673680918620, doi101016s0140673684907645, doi101093infdis1633464, doi101093oxfordjournalsajea116770, doi1010970000645419950600000002, doi1010970000645419981000000004, doi1010970000645419981100000004, doi1010970000645419990200000004, doi101128jcm3111111171993, doi101128jcm3625395421998"
}

New diagnostic techniques such as pneumococcal serologies and polymerase chain reaction testing have improved the ability to determine the microbiologic etiology of childhood pneumonia. Because these tests are not generally available, empiric treatment is necessary. Efforts to identify new intervention strategies, diagnostic tools, therapies and vaccines will be helpful in managing this disease.

@article{doi1010970000645420000900000036,
    author = "McCracken, George H.",
    title = "Diagnosis and management of pneumonia in children",
    year = "2000",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "New diagnostic techniques such as pneumococcal serologies and polymerase chain reaction testing have improved the ability to determine the microbiologic etiology of childhood pneumonia. Because these tests are not generally available, empiric treatment is necessary. Efforts to identify new intervention strategies, diagnostic tools, therapies and vaccines will be helpful in managing this disease.",
    url = "https://doi.org/10.1097/00006454-200009000-00036",
    doi = "10.1097/00006454-200009000-00036",
    openalex = "W2162578723",
    references = "nelson2000communityacquired"
}

Most hospitalized patients with CAP receive antimicrobial therapy consistent with the ATS guidelines. The addition of a macrolide may be associated with improved patient outcomes.

@article{doi101345aph19174,
    author = "Dudas, Vicky and Hopefl, Alan W. and Jacobs, Richard A. and Guglielmo, B. Joseph",
    title = "Antimicrobial Selection for Hospitalized Patients with Presumed Community-Acquired Pneumonia: A Survey of Nonteaching US Community Hospitals",
    year = "2000",
    journal = "Annals of Pharmacotherapy",
    abstract = "Most hospitalized patients with CAP receive antimicrobial therapy consistent with the ATS guidelines. The addition of a macrolide may be associated with improved patient outcomes.",
    url = "https://doi.org/10.1345/aph.19174",
    doi = "10.1345/aph.19174",
    openalex = "W2114927388"
}

@article{nelson2000communityacquired,
    author = "Nelson, John D.",
    title = "Community-acquired pneumonia in children: guidelines for treatment",
    year = "2000",
    journal = "The Pediatric Infectious Disease Journal",
    url = "https://doi.org/10.1097/00006454-200003000-00016",
    doi = "10.1097/00006454-200003000-00016",
    number = "3",
    openalex = "W2130533227",
    pages = "251-253",
    volume = "19"
}

These guidelines from the Infectious Diseases Society of America (IDSA), the American College of Critical Care Medicine (for the Society of Critical Care Medicine), and the Society for Healthcare Epidemiology of America contain recommendations for the management of adults and children with, and diagnosis of infections related to, peripheral and nontunneled central venous catheters (CVCs), pulmonary artery catheters, tunneled central catheters, and implantable devices. The guidelines, written for clinicians, contain IDSA evidence-based recommendations for assessment of the quality and strength of the data. Recommendations are presented according to the type of catheter, the infecting organism, and the associated complications. Intravascular catheter-related infections are a major cause of morbidity and mortality in the United States. Coagulase-negative staphylococci, Staphylococcus aureus, aerobic gram-negative bacilli, and Candida albicans most commonly cause catheter-related bloodstream infection. Management of catheter-related infection varies according to the type of catheter involved. After appropriate cultures of blood and catheter samples are done, empirical i.v. antimicrobial therapy should be initiated on the basis of clinical clues, the severity of the patient's acute illness, underlying disease, and the potential pathogen(s) involved. In most cases of nontunneled CVC-related bacteremia and fungemia, the CVC should be removed. For management of bacteremia and fungemia from a tunneled catheter or implantable device, such as a port, the decision to remove the catheter or device should be based on the severity of the patient's illness, documentation that the vascular-access device is infected, assessment of the specific pathogen involved, and presence of complications, such as endocarditis, septic thrombosis, tunnel infection, or metastatic seeding. When a catheter-related infection is documented and a specific pathogen is identified, systemic antimicrobial therapy should be narrowed and consideration given for antibiotic lock therapy, if the CVC or implantable device is not removed. These guidelines address the issues related to the management of catheter-related bacteremia and associated complications. Separate guidelines will address specific issues related to the prevention of catheter-related infections. Performance indicators for the management of catheter-related infection are included at the end of the document. Because the pathogenesis of catheter-related infections is complicated, the virulence of the pathogens is variable, and the host factors have not been well defined, there is a notable absence of compelling clinical data to make firm recommendations for an individual patient. Therefore, the recommendations in these guidelines are intended to support, and not replace, good clinical judgment. Also, a section on selected, unresolved clinical issues that require further study and research has been included. There is an urgent need for large, well-designed clinical studies to delineate management strategies more effectively, which will improve clinical outcomes and save precious health care resources.

@article{doi101086320001,
    author = "Mermel, Leonard A. and Farr, Barry M. and Sherertz, Robert J. and Raad, Issam and O’Grady, Naomi P. and Harris, Jo-Ann and Craven, Donald E.",
    title = "Guidelines for the Management of Intravascular Catheter-Related Infections",
    year = "2001",
    journal = "Clinical Infectious Diseases",
    abstract = "These guidelines from the Infectious Diseases Society of America (IDSA), the American College of Critical Care Medicine (for the Society of Critical Care Medicine), and the Society for Healthcare Epidemiology of America contain recommendations for the management of adults and children with, and diagnosis of infections related to, peripheral and nontunneled central venous catheters (CVCs), pulmonary artery catheters, tunneled central catheters, and implantable devices. The guidelines, written for clinicians, contain IDSA evidence-based recommendations for assessment of the quality and strength of the data. Recommendations are presented according to the type of catheter, the infecting organism, and the associated complications. Intravascular catheter-related infections are a major cause of morbidity and mortality in the United States. Coagulase-negative staphylococci, Staphylococcus aureus, aerobic gram-negative bacilli, and Candida albicans most commonly cause catheter-related bloodstream infection. Management of catheter-related infection varies according to the type of catheter involved. After appropriate cultures of blood and catheter samples are done, empirical i.v. antimicrobial therapy should be initiated on the basis of clinical clues, the severity of the patient's acute illness, underlying disease, and the potential pathogen(s) involved. In most cases of nontunneled CVC-related bacteremia and fungemia, the CVC should be removed. For management of bacteremia and fungemia from a tunneled catheter or implantable device, such as a port, the decision to remove the catheter or device should be based on the severity of the patient's illness, documentation that the vascular-access device is infected, assessment of the specific pathogen involved, and presence of complications, such as endocarditis, septic thrombosis, tunnel infection, or metastatic seeding. When a catheter-related infection is documented and a specific pathogen is identified, systemic antimicrobial therapy should be narrowed and consideration given for antibiotic lock therapy, if the CVC or implantable device is not removed. These guidelines address the issues related to the management of catheter-related bacteremia and associated complications. Separate guidelines will address specific issues related to the prevention of catheter-related infections. Performance indicators for the management of catheter-related infection are included at the end of the document. Because the pathogenesis of catheter-related infections is complicated, the virulence of the pathogens is variable, and the host factors have not been well defined, there is a notable absence of compelling clinical data to make firm recommendations for an individual patient. Therefore, the recommendations in these guidelines are intended to support, and not replace, good clinical judgment. Also, a section on selected, unresolved clinical issues that require further study and research has been included. There is an urgent need for large, well-designed clinical studies to delineate management strategies more effectively, which will improve clinical outcomes and save precious health care resources.",
    url = "https://doi.org/10.1086/320001",
    doi = "10.1086/320001",
    openalex = "W2104851340",
    references = "doi101093clinids183421"
}

@article{doi101164ajrccm1637at1010,
    author = "Niederman, Michael S. and Mandell, Lionel A. and Anzueto, Antonio and Bass, John B. and Broughton, William A. and Campbell, G. Douglas and Dean, Nathan C. and File, Thomas M. and Fine, Michael J. and Groß, Peter and Martínez, Fernando J. and Marrie, Thomas J. and Plouffe, Joseph F. and Ramírez, Julio A. and Sarosi, George A. and Torres, Antoní and Wilson, Rob and Yu, Victor L.",
    title = "Guidelines for the Management of Adults with Community-acquired Pneumonia",
    year = "2001",
    journal = "American Journal of Respiratory and Critical Care Medicine",
    url = "https://doi.org/10.1164/ajrccm.163.7.at1010",
    doi = "10.1164/ajrccm.163.7.at1010",
    openalex = "W2123324969",
    references = "doi101056nejm199512143332408, doi101056nejm199907223410403, doi101056nejm200012283432603, doi101086313954, doi101086313959"
}

@article{file2001communityacquired,
    author = "File, Thomas M.",
    title = "Community-acquired pneumonia: new guidelines for management",
    year = "2001",
    journal = "Current Opinion in Infectious Diseases",
    url = "https://doi.org/10.1097/00001432-200104000-00009",
    doi = "10.1097/00001432-200104000-00009",
    number = "2",
    openalex = "W2081858562",
    pages = "161-164",
    volume = "14",
    references = "doi101001archinte159212562, doi101001archinte160101399, doi101086313954, doi101086313959, doi101086313976, doi101086318157, doi101345aph19174, openalexw3004715361"
}

@article{niederman2001guidelines,
    author = "Niederman, Michael S.",
    title = "GUIDELINES FOR THE MANAGEMENT OS COMMUNITY-ACQUIRED PNEUMONIA",
    year = "2001",
    journal = "Medical Clinics of North America",
    url = "https://doi.org/10.1016/s0025-7125(05)70392-8",
    doi = "10.1016/s0025-7125(05)70392-8",
    number = "6",
    openalex = "W2034780492",
    pages = "1493-1509",
    volume = "85",
    references = "bartlett1998communityacquired, doi101001archinte199700440360129015, doi101001jama199703550230056037, doi101056nejm199508243330802, doi101056nejm199701233360402, doi101056nejm199907223410403, doi101056nejm200012283432603, doi101086313954, doi101164ajrccm14851418, doi101164ajrccm1637at1010"
}

@article{doi101016s1368764602000183,
    author = "Esposito, Susanna and Principi, Nicola",
    title = "Emerging resistance to antibiotics against respiratory bacteria: impact on therapy of community-acquired pneumonia in children",
    year = "2002",
    journal = "Drug Resistance Updates",
    url = "https://doi.org/10.1016/s1368-7646(02)00018-3",
    doi = "10.1016/s1368-7646(02)00018-3",
    openalex = "W1977794384",
    references = "file2001communityacquired"
}

Pneumonia remains a common and potentially serious infection in children. This review summarizes the problems involved in making the diagnosis and establishing a cause and offers a practical guide to treatment. Decisions should be based first on the age of the child, then on clinical and epidemiologic considerations, and finally, on the findings on chest radiography.

@article{doi101056nejmra011994,
    author = "McIntosh, Kenneth",
    title = "Community-Acquired Pneumonia in Children",
    year = "2002",
    journal = "New England Journal of Medicine",
    abstract = "Pneumonia remains a common and potentially serious infection in children. This review summarizes the problems involved in making the diagnosis and establishing a cause and offers a practical guide to treatment. Decisions should be based first on the age of the child, then on clinical and epidemiologic considerations, and finally, on the findings on chest radiography.",
    url = "https://doi.org/10.1056/nejmra011994",
    doi = "10.1056/nejmra011994",
    openalex = "W2088746631",
    references = "doi101056nejm199508243330802, doi101056nejm200102083440602, doi101086313954, doi101093clinids12supplements870, doi101093infdis1614618, doi101093oxfordjournalsajea116770, doi1010970000645419981100000004, doi1010970000645420000300000003, doi1010970000645420000400000006, doi101164ajrccm14851418"
}

The antibiotic management of infants and children with pneumonia is based on the clinician's assessment of the most likely infecting pathogens, the susceptibilities of the infecting pathogens and the seriousness of the illness. The bacterial etiology of pneumonia changed significantly following the universal use of protein-conjugated vaccines for Haemophilus influenzae type b. Similar significant changes are likely to occur with universal use of protein-conjugated vaccines for Streptococcus pneumoniae, requiring the clinician to alter assumptions of the risk of invasive bacterial infection in the child who presents with pneumonia. New strategies are likely to require fewer ancillary tests (e.g. white blood cell count, C-reactive protein and blood culture) and suggest a decreased need for empiric antibiotic therapy. Although the majority of lower respiratory tract infections in children have a viral etiology and are not amenable to antibiotic therapy, for the seriously ill child who is thought to be likely to have pneumonia caused by a bacterial pathogen, recent changes in the susceptibility patterns of both common organisms such as S. pneumoniae and more unusual pulmonary pathogens such as Staphylococcus aureus have forced changes in the selection of both empiric and definitive antibiotic therapy. Third generation cephalosporins ceftriaxone and cefotaxime appear to be effective therapy for pneumonia caused by virtually all current isolates of S. pneumoniae. In contrast antibiotic regimens for life-threatening pulmonary infections in which Staphylococcus aureus is a suspected pathogen should include vancomycin.

@article{doi1010970000645420020600000035,
    author = "Bradley, John S.",
    title = "Management of community-acquired pediatric pneumonia in an era of increasing antibiotic resistance and conjugate vaccines",
    year = "2002",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "The antibiotic management of infants and children with pneumonia is based on the clinician's assessment of the most likely infecting pathogens, the susceptibilities of the infecting pathogens and the seriousness of the illness. The bacterial etiology of pneumonia changed significantly following the universal use of protein-conjugated vaccines for Haemophilus influenzae type b. Similar significant changes are likely to occur with universal use of protein-conjugated vaccines for Streptococcus pneumoniae, requiring the clinician to alter assumptions of the risk of invasive bacterial infection in the child who presents with pneumonia. New strategies are likely to require fewer ancillary tests (e.g. white blood cell count, C-reactive protein and blood culture) and suggest a decreased need for empiric antibiotic therapy. Although the majority of lower respiratory tract infections in children have a viral etiology and are not amenable to antibiotic therapy, for the seriously ill child who is thought to be likely to have pneumonia caused by a bacterial pathogen, recent changes in the susceptibility patterns of both common organisms such as S. pneumoniae and more unusual pulmonary pathogens such as Staphylococcus aureus have forced changes in the selection of both empiric and definitive antibiotic therapy. Third generation cephalosporins ceftriaxone and cefotaxime appear to be effective therapy for pneumonia caused by virtually all current isolates of S. pneumoniae. In contrast antibiotic regimens for life-threatening pulmonary infections in which Staphylococcus aureus is a suspected pathogen should include vancomycin.",
    url = "https://doi.org/10.1097/00006454-200206000-00035",
    doi = "10.1097/00006454-200206000-00035",
    openalex = "W2048490039",
    references = "nelson2000communityacquired"
}

The pneumococcal conjugate vaccine tested was effective in reducing the risk of pneumonia in young children.

@article{doi1010970000645420020900000005,
    author = "Black, Steven and Shinefield, Henry R. and Ling, Stella and Hansen, John and Fireman, Bruce and Spring, David B. and Noyes, J. F. and Lewis, Edwin and Ray, Paula and Lee, Janelle and Hackell, Jill",
    title = "Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia",
    year = "2002",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "The pneumococcal conjugate vaccine tested was effective in reducing the risk of pneumonia in young children.",
    url = "https://doi.org/10.1097/00006454-200209000-00005",
    doi = "10.1097/00006454-200209000-00005",
    openalex = "W2049386698",
    references = "doi101001jama283111460, doi101001jama285131729, doi101056nejm200102083440602, doi10108001621459198910478874, doi101086313609, doi101093infdis1481131, doi101093infdis1702368, doi1010970000645420000300000003, doi101214aos1176345976, doi1023072290085"
}

These guidelines have been replaced by 2011 Guideline: BTS Guidelines for the Management of Community Acquired Pneumonia in Childhood Superseded By 2011 Guideline: BTS Guidelines for the Management of Community Acquired Pneumonia in Childhood. Thorax 2002 May; 57(Suppl 1): 1–24.

@article{doi101136thx57suppl1i1,
    author = "of Standards of Care Committee, British Thoracic Society",
    title = "BTS Guidelines for the Management of Community Acquired Pneumonia in Childhood",
    year = "2002",
    journal = "Thorax",
    abstract = "These guidelines have been replaced by 2011 Guideline: BTS Guidelines for the Management of Community Acquired Pneumonia in Childhood Superseded By 2011 Guideline: BTS Guidelines for the Management of Community Acquired Pneumonia in Childhood. Thorax 2002 May; 57(Suppl 1): 1–24.",
    url = "https://doi.org/10.1136/thx.57.suppl\_1.i1",
    doi = "10.1136/thx.57.suppl\_1.i1",
    openalex = "W1743323259"
}

@article{file2002communityacquired,
    author = "File, Thomas M.",
    title = "COMMUNITY-ACQUIRED PNEUMONIA: NEW GUIDELINES FOR MANAGEMENT*",
    year = "2002",
    journal = "Infectious Diseases in Clinical Practice",
    url = "https://doi.org/10.1097/00019048-200202000-00006",
    doi = "10.1097/00019048-200202000-00006",
    number = "2",
    openalex = "W2019125039",
    pages = "72-75",
    volume = "11",
    references = "doi101001archinte159212562, doi101086313954, doi101086313959, doi101086313976, doi101086318157, doi101345aph19174, openalexw3004715361"
}

@article{doi101016s0140673603150210,
    author = "File, Thomas M.",
    title = "Community-acquired pneumonia",
    year = "2003",
    journal = "The Lancet",
    url = "https://doi.org/10.1016/s0140-6736(03)15021-0",
    doi = "10.1016/s0140-6736(03)15021-0",
    openalex = "W2077441600",
    references = "doi101086313959, doi101086380488, doi101542peds1134701"
}

Recent antibiotic therapy b A respiratory fluoroquinolone c alone, an advanced macrolide d plus high-dose amoxicillin, e or an advanced macrolide plus high-dose amoxicillin-clavulanate f Comorbidities (COPD, diabetes, renal or congestive heart failure, or malignancy) No recent antibiotic therapy An advanced macrolide d or a respiratory fluoroquinolone Recent antibiotic therapy A respiratory fluoroquinolone c alone or an advanced macrolide plus a b-lactam g Suspected aspiration with infection Amoxicillin-clavulanate or clindamycin Influenza with bacterial superinfection A b-lactam g or a respiratory fluoroquinolone Inpatient Medical ward No recent antibiotic therapy A respiratory fluoroquinolone alone or an advanced macrolide plus a b-lactam h Recent antibiotic therapy An advanced macrolide plus a b-lactam or a respiratory fluoroquinolone alone (regimen selected will depend on nature of recent antibiotic therapy) ICU Pseudomonas infection is not an issue A b-lactam h plus either an advanced macrolide or a respiratory fluoroquinolone Pseudomonas infection is not an issue but patient has a b-lactam allergy A respiratory fluoroquinolone, with or without clindamycin Pseudomonas infection is an issue i Either (1) an antipseudomonal agent j plus ciprofloxacin, or (2) an antipseudomonal agent plus an aminoglycoside k plus a respiratory fluoroquinolone or a macrolide Pseudomonas infection is an issue but the patient has a b-lactam allergy Either (1) aztreonam plus levofloxacin, l or (2) aztreonam plus moxifloxacin or gatifloxacin, with or without an aminoglycoside Nursing home Receiving treatment in nursing home A respiratory fluoroquinolone alone or amoxicillin-clavulanate plus an advanced macrolide Hospitalized Same as for medical ward and ICU NOTE. COPD, chronic obstructive pulmonary disease; ICU, intensive care unit. a Erythromycin, azithromycin, or clarithromycin.

@article{doi101086380488,
    author = "Mandell, Lionel A. and Bartlett, John G. and Dowell, Scott F. and File, Thomas M. and Musher, Daniel M. and Whitney, Cynthia G.",
    title = "Update of Practice Guidelines for the Management of Community-Acquired Pneumonia in Immunocompetent Adults",
    year = "2003",
    journal = "Clinical Infectious Diseases",
    abstract = "Recent antibiotic therapy b A respiratory fluoroquinolone c alone, an advanced macrolide d plus high-dose amoxicillin, e or an advanced macrolide plus high-dose amoxicillin-clavulanate f Comorbidities (COPD, diabetes, renal or congestive heart failure, or malignancy) No recent antibiotic therapy An advanced macrolide d or a respiratory fluoroquinolone Recent antibiotic therapy A respiratory fluoroquinolone c alone or an advanced macrolide plus a b-lactam g Suspected aspiration with infection Amoxicillin-clavulanate or clindamycin Influenza with bacterial superinfection A b-lactam g or a respiratory fluoroquinolone Inpatient Medical ward No recent antibiotic therapy A respiratory fluoroquinolone alone or an advanced macrolide plus a b-lactam h Recent antibiotic therapy An advanced macrolide plus a b-lactam or a respiratory fluoroquinolone alone (regimen selected will depend on nature of recent antibiotic therapy) ICU Pseudomonas infection is not an issue A b-lactam h plus either an advanced macrolide or a respiratory fluoroquinolone Pseudomonas infection is not an issue but patient has a b-lactam allergy A respiratory fluoroquinolone, with or without clindamycin Pseudomonas infection is an issue i Either (1) an antipseudomonal agent j plus ciprofloxacin, or (2) an antipseudomonal agent plus an aminoglycoside k plus a respiratory fluoroquinolone or a macrolide Pseudomonas infection is an issue but the patient has a b-lactam allergy Either (1) aztreonam plus levofloxacin, l or (2) aztreonam plus moxifloxacin or gatifloxacin, with or without an aminoglycoside Nursing home Receiving treatment in nursing home A respiratory fluoroquinolone alone or amoxicillin-clavulanate plus an advanced macrolide Hospitalized Same as for medical ward and ICU NOTE. COPD, chronic obstructive pulmonary disease; ICU, intensive care unit. a Erythromycin, azithromycin, or clarithromycin.",
    url = "https://doi.org/10.1086/380488",
    doi = "10.1086/380488",
    openalex = "W2142230428",
    references = "bartlett1998communityacquired, doi101001jama281222127, doi101001jama2892179, doi1010160002934394900604, doi101016s0140673603134125, doi101056nejm199907223410403, doi101056nejmoa022823, doi101056nejmoa030685, doi101056nejmoa030747, doi101056nejmoa030781, doi101086313954, doi101086313959, doi101093infdis17511, doi101126science1085952, doi101164ajrccm1637at1010"
}

A simple six point score based on confusion, urea, respiratory rate, blood pressure, and age can be used to stratify patients with CAP into different management groups.

@article{doi101136thorax585377,
    author = "Lim, Wei Shen",
    title = "Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study",
    year = "2003",
    journal = "Thorax",
    abstract = "A simple six point score based on confusion, urea, respiratory rate, blood pressure, and age can be used to stratify patients with CAP into different management groups.",
    url = "https://doi.org/10.1136/thorax.58.5.377",
    doi = "10.1136/thorax.58.5.377",
    openalex = "W2102361557",
    references = "doi101086313954, doi101086313959"
}

Streptococcus pneumoniae is suspected to cause an important proportion of community-acquired pneumonia (CAP) whose aetiology cannot be detected with conventional tests. In this study, the authors evaluated the diagnostic yield of a new immunochromatographic membrane test (ICT) for the detection of the S. pneumoniae antigen in the urine of patients admitted with diagnosed CAP. ICT was performed in unconcentrated and concentrated urine from all the patients. ICT was repeated 1 month after discharge in a group initially testing positive. The authors also studied the ICT in clinically stable human immunodeficiency virus type 1 (HIV1)-infected patients. S. pneumoniae antigen was detected in all of the 68 (100%) patients tested with definitive pneumococcal pneumonia. In five of these cases ICT was only positive when it had been performed on the patients. The S. pneumoniae antigen was also detected in 36 (69.2%) of 52 patients with probable pneumococcal pneumonia and in 50 of 277 (18%) patients without pneumococcal pneumonia. ICT remained positive in 16 (69.5%) of 23 patients, 1 month after hospital discharge. Nasopharyngeal colonisation with S. pneumoniae was detected in 8 (12%) of 68 clinically stable HIV1 infected patients, but none tested ICT positive. The Binax NOW it immunochromatographic membrane test is a rapid, sensitive and specific test for detecting pneumococcal community-acquired pneumonia in adults. The test may remain positive for several weeks after pneumococcal pneumonia.

@article{doi101183090319360300058802,
    author = "Marcos, María Ángeles and de Anta, M. T. Jiménez and de la Bellacasa, Jordi Puig and González, J. and Martínez, Estebán and Torres-Garcı́a, E. and Mensa, Josep and de Roux, A and Torres, Antoní",
    title = "Rapid urinary antigen test for diagnosis of pneumococcal community-acquired pneumonia in adults",
    year = "2003",
    journal = "European Respiratory Journal",
    abstract = "Streptococcus pneumoniae is suspected to cause an important proportion of community-acquired pneumonia (CAP) whose aetiology cannot be detected with conventional tests. In this study, the authors evaluated the diagnostic yield of a new immunochromatographic membrane test (ICT) for the detection of the S. pneumoniae antigen in the urine of patients admitted with diagnosed CAP. ICT was performed in unconcentrated and concentrated urine from all the patients. ICT was repeated 1 month after discharge in a group initially testing positive. The authors also studied the ICT in clinically stable human immunodeficiency virus type 1 (HIV1)-infected patients. S. pneumoniae antigen was detected in all of the 68 (100\%) patients tested with definitive pneumococcal pneumonia. In five of these cases ICT was only positive when it had been performed on the patients. The S. pneumoniae antigen was also detected in 36 (69.2\%) of 52 patients with probable pneumococcal pneumonia and in 50 of 277 (18\%) patients without pneumococcal pneumonia. ICT remained positive in 16 (69.5\%) of 23 patients, 1 month after hospital discharge. Nasopharyngeal colonisation with S. pneumoniae was detected in 8 (12\%) of 68 clinically stable HIV1 infected patients, but none tested ICT positive. The Binax NOW it immunochromatographic membrane test is a rapid, sensitive and specific test for detecting pneumococcal community-acquired pneumonia in adults. The test may remain positive for several weeks after pneumococcal pneumonia.",
    url = "https://doi.org/10.1183/09031936.03.00058802",
    doi = "10.1183/09031936.03.00058802",
    openalex = "W2164351477",
    references = "niederman2001guidelines"
}

Community-acquired pneumonia (CAP) is one of the most frequent infections in childhood but it is not easy to establish a rational therapeutic approach for a number of reasons, including difficulties in identifying the aetiology, the fact that the most frequent bacterial pathogens become resistant to commonly used antibiotics and the lack of certain information concerning the possible preventive role of conjugate vaccines. This leads paediatricians to treat almost all cases of CAP with antibiotics, often using a combination of different antimicrobial classes. In order to avoid unnecessary antibiotic use and limit the spread of antibiotic resistance, consensus guidelines for the management of CAP in childhood should be developed and used by practitioners in their offices and hospitals.

@article{doi1015171465656645761,
    author = "Principi, Nicola and Esposito, Susanna",
    title = "Paediatric community-acquired pneumonia: current concept in pharmacological control",
    year = "2003",
    journal = "Expert Opinion on Pharmacotherapy",
    abstract = "Community-acquired pneumonia (CAP) is one of the most frequent infections in childhood but it is not easy to establish a rational therapeutic approach for a number of reasons, including difficulties in identifying the aetiology, the fact that the most frequent bacterial pathogens become resistant to commonly used antibiotics and the lack of certain information concerning the possible preventive role of conjugate vaccines. This leads paediatricians to treat almost all cases of CAP with antibiotics, often using a combination of different antimicrobial classes. In order to avoid unnecessary antibiotic use and limit the spread of antibiotic resistance, consensus guidelines for the management of CAP in childhood should be developed and used by practitioners in their offices and hospitals.",
    url = "https://doi.org/10.1517/14656566.4.5.761",
    doi = "10.1517/14656566.4.5.761",
    openalex = "W2034260919",
    references = "file2001communityacquired"
}

The initial management of patients suspected of having community-acquired pneumonia is challenging because of the broad range of clinical presentations, potential life-threatening nature of the illness, and associated high costs of care. The initial testing strategies should accurately establish a diagnosis and prognosis in order to determine the optimal treatment strategy. The diagnosis is important in determining the need for antibiotic therapy, and the prognosis is important in determining the site of care. This paper reviews the test characteristics of the history, physical examination, and laboratory findings, individually and in combination, in diagnosing community-acquired pneumonia and predicting short-term risk for death from the infection. In addition, we consider the implications of these test characteristics from the perspective of decision thresholds. The history and physical examination cannot provide a high level of certainty in the diagnosis of community-acquired pneumonia, but the absence of vital sign abnormalities substantially reduces the probability of the infection. Chest radiography is considered the gold standard for pneumonia diagnosis; however, we do not know its sensitivity and specificity, and we have limited data on the costs of false-positive and false-negative results. In the absence of empirical evidence, the decision to order a chest radiograph needs to rely on expert opinion in seeking strategies to optimize the balance between harms and benefits. Once community-acquired pneumonia is diagnosed, a combination of history, physical examination, and laboratory items can help estimate the short-term risk for death and, along with the patient's psychosocial characteristics, determine the appropriate site of treatment.

@article{doi10732600034819138220030121000012,
    author = "Metlay, Joshua P. and Fine, Michael J.",
    title = "Testing Strategies in the Initial Management of Patients with Community-Acquired Pneumonia",
    year = "2003",
    journal = "Annals of Internal Medicine",
    abstract = "The initial management of patients suspected of having community-acquired pneumonia is challenging because of the broad range of clinical presentations, potential life-threatening nature of the illness, and associated high costs of care. The initial testing strategies should accurately establish a diagnosis and prognosis in order to determine the optimal treatment strategy. The diagnosis is important in determining the need for antibiotic therapy, and the prognosis is important in determining the site of care. This paper reviews the test characteristics of the history, physical examination, and laboratory findings, individually and in combination, in diagnosing community-acquired pneumonia and predicting short-term risk for death from the infection. In addition, we consider the implications of these test characteristics from the perspective of decision thresholds. The history and physical examination cannot provide a high level of certainty in the diagnosis of community-acquired pneumonia, but the absence of vital sign abnormalities substantially reduces the probability of the infection. Chest radiography is considered the gold standard for pneumonia diagnosis; however, we do not know its sensitivity and specificity, and we have limited data on the costs of false-positive and false-negative results. In the absence of empirical evidence, the decision to order a chest radiograph needs to rely on expert opinion in seeking strategies to optimize the balance between harms and benefits. Once community-acquired pneumonia is diagnosed, a combination of history, physical examination, and laboratory items can help estimate the short-term risk for death and, along with the patient's psychosocial characteristics, determine the appropriate site of treatment.",
    url = "https://doi.org/10.7326/0003-4819-138-2-200301210-00012",
    doi = "10.7326/0003-4819-138-2-200301210-00012",
    openalex = "W1989951598",
    references = "doi1010160021968184901498"
}

Current use of gastric acid-suppressive therapy was associated with an increased risk of community-acquired pneumonia.

@article{doi101001jama292161955,
    author = "Laheij, Robert J.F.",
    title = "Risk of Community-Acquired Pneumonia and Use of Gastric Acid–Suppressive Drugs",
    year = "2004",
    journal = "JAMA",
    abstract = "Current use of gastric acid-suppressive therapy was associated with an increased risk of community-acquired pneumonia.",
    url = "https://doi.org/10.1001/jama.292.16.1955",
    doi = "10.1001/jama.292.16.1955",
    openalex = "W2113443314",
    references = "doi101056nejm199512143332408"
}

@article{doi101007s0043100313972,
    author = "Juvén, Taina and Mertsola, Jussi and Waris, Matti and Leinonen, Maija and Ruuskanen, Olli",
    title = "Clinical response to antibiotic therapy for community-acquired pneumonia",
    year = "2004",
    journal = "European Journal of Pediatrics",
    url = "https://doi.org/10.1007/s00431-003-1397-2",
    doi = "10.1007/s00431-003-1397-2",
    openalex = "W2023166771",
    references = "nelson2000communityacquired"
}

This study of the pharmacokinetics of beta-lactam antibiotics in children with bacterial pneumonia may help in the development of therapeutic guidelines for the treatment of pneumococcal pneumonia.

@article{doi10109701inf000012878311218c9,
    author = "Giachetto, Gustavo and a Catalina Pirez, Mar and Nanni, Luciana and nez, Adriana Mart and Montano, Alicia and Algorta, Gabriela and Kaplan, Sheldon L. and Ferrari, Ana",
    title = "Ampicillin and Penicillin Concentration in Serum and Pleural Fluid of Hospitalized Children With Community-Acquired Pneumonia",
    year = "2004",
    journal = "The Pediatric Infectious Disease Journal",
    abstract = "This study of the pharmacokinetics of beta-lactam antibiotics in children with bacterial pneumonia may help in the development of therapeutic guidelines for the treatment of pneumococcal pneumonia.",
    url = "https://doi.org/10.1097/01.inf.0000128783.11218.c9",
    doi = "10.1097/01.inf.0000128783.11218.c9",
    openalex = "W2096172428",
    references = "nelson2000communityacquired"
}

@article{doi101378chest12551888,
    author = "File, Thomas M. and Garau, Javier and Blasi, Francesco and Chidiac, Christian and Klugman, Keith P. and Lode, H. and Lonks, John R. and Mandell, Lionel A. and Ramírez, Julio A. and Yu, Victor L.",
    title = "Guidelines for Empiric Antimicrobial Prescribing in Community-Acquired Pneumonia",
    year = "2004",
    journal = "CHEST Journal",
    url = "https://doi.org/10.1378/chest.125.5.1888",
    doi = "10.1378/chest.125.5.1888",
    openalex = "W2057024099",
    references = "crossref1998guidelines, niederman2001guidelines"
}

This study used an expanded diagnostic armamentarium to define the broad spectrum of pathogens that cause pneumonia in hospitalized children. The data confirm the importance of S pneumoniae and the frequent occurrence of bacterial and viral coinfections in children with pneumonia. These findings will facilitate age-appropriate antibiotic selection and future evaluation of the clinical effectiveness of the pneumococcal conjugate vaccine as well as other candidate vaccines.

@article{doi101542peds1134701,
    author = "Michelow, Ian C. and Olsen, Kurt and Lozano, Juanita and Rollins, Nancy and Duffy, Lynn B. and Ziegler, Thedi and Kauppila, Jaana and Leinonen, Maija and McCracken, George H.",
    title = "Epidemiology and Clinical Characteristics of Community-Acquired Pneumonia in Hospitalized Children",
    year = "2004",
    journal = "PEDIATRICS",
    abstract = "This study used an expanded diagnostic armamentarium to define the broad spectrum of pathogens that cause pneumonia in hospitalized children. The data confirm the importance of S pneumoniae and the frequent occurrence of bacterial and viral coinfections in children with pneumonia. These findings will facilitate age-appropriate antibiotic selection and future evaluation of the clinical effectiveness of the pneumococcal conjugate vaccine as well as other candidate vaccines.",
    url = "https://doi.org/10.1542/peds.113.4.701",
    doi = "10.1542/peds.113.4.701",
    openalex = "W2074305241",
    references = "doi101016b9780125838061x51098, doi101016s0140673602113912, doi101056nejmra011994, doi101086313772, doi1010970000645419950600000002, doi1010970000645419981100000004, doi1010970000645419990200000004, doi1010970000645420000400000006, doi1010970000645420020900000005, doi101136thx57suppl1i1"
}

@article{flanders2004guidelines,
    author = "Flanders, Scott A and Halm, Ethan A",
    title = "Guidelines for Community-Acquired Pneumonia",
    year = "2004",
    journal = "Treatments in Respiratory Medicine",
    url = "https://doi.org/10.2165/00151829-200403020-00001",
    doi = "10.2165/00151829-200403020-00001",
    number = "2",
    openalex = "W1547178202",
    pages = "67-77",
    volume = "3",
    references = "bartlett1998communityacquired, doi101001jama199703550230056037, doi101001jama281201900, doi101001jama282151458, doi101001jama2836749, doi101056nejm199701233360402, doi101086313954, doi101136bmj3177162858, doi101164ajrccm14851418, doi101164ajrccm1637at1010"
}

Community-acquired pneumonia is one of the most common serious infections in children, with an annual incidence of 34 to 40 cases per 1,000 children in Europe and North America. When diagnosing community-acquired pneumonia, physicians should rely mainly on the patient's history and physical examination, supplemented by judicious use of chest radiographs and laboratory tests as needed. The child's age is important in making the diagnosis. Pneumonia in neonates younger than three weeks of age most often is caused by an infection obtained from the mother at birth. Streptococcus pneumoniae and viruses are the most common causes in infants three weeks to three months of age. Viruses are the most frequent cause of pneumonia in preschool-aged children; Streptococcus pneumoniae is the most common bacterial pathogen. Mycoplasma pneumoniae and Chlamydia pneumoniae often are the etiologic agents in children older than five years and in adolescents. In very young children who appear toxic, hospitalization and intravenous antibiotics are needed. The symptoms in outpatients who present with community-acquired pneumonia can help determine the treatment. Knowing the age-specific causes of bacterial pneumonia will help guide antibiotic therapy. Childhood immunization has helped decrease the incidence of invasive Haemophilus influenzae type B infection, and the newly introduced heptavalent pneumococcal vaccine may do the same for Streptococcus pneumoniae infections.

@article{openalexw202319948,
    author = "Ostapchuk, Michael and Roberts, Donna M. and Haddy, Richard I.",
    title = "Community-acquired pneumonia in infants and children.",
    year = "2004",
    journal = "PubMed",
    abstract = "Community-acquired pneumonia is one of the most common serious infections in children, with an annual incidence of 34 to 40 cases per 1,000 children in Europe and North America. When diagnosing community-acquired pneumonia, physicians should rely mainly on the patient's history and physical examination, supplemented by judicious use of chest radiographs and laboratory tests as needed. The child's age is important in making the diagnosis. Pneumonia in neonates younger than three weeks of age most often is caused by an infection obtained from the mother at birth. Streptococcus pneumoniae and viruses are the most common causes in infants three weeks to three months of age. Viruses are the most frequent cause of pneumonia in preschool-aged children; Streptococcus pneumoniae is the most common bacterial pathogen. Mycoplasma pneumoniae and Chlamydia pneumoniae often are the etiologic agents in children older than five years and in adolescents. In very young children who appear toxic, hospitalization and intravenous antibiotics are needed. The symptoms in outpatients who present with community-acquired pneumonia can help determine the treatment. Knowing the age-specific causes of bacterial pneumonia will help guide antibiotic therapy. Childhood immunization has helped decrease the incidence of invasive Haemophilus influenzae type B infection, and the newly introduced heptavalent pneumococcal vaccine may do the same for Streptococcus pneumoniae infections.",
    openalex = "W202319948",
    references = "nelson2000communityacquired"
}

@article{doi101007s1014000504134,
    author = "Campbell, Samuel and Murray, D. and Hawass, Ammar and Urquhart, David G. and Ackroyd‐Stolarz, Stacy and Maxwell, David",
    title = "Agreement between emergency physician diagnosis and radiologist reports in patients discharged from an emergency department with community-acquired pneumonia",
    year = "2005",
    journal = "Emergency Radiology",
    url = "https://doi.org/10.1007/s10140-005-0413-4",
    doi = "10.1007/s10140-005-0413-4",
    openalex = "W2069317264",
    references = "crossref1998guidelines"
}

@article{doi101164rccm200405644st,
    title = "Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia",
    year = "2005",
    journal = "American Journal of Respiratory and Critical Care Medicine",
    url = "https://doi.org/10.1164/rccm.200405-644st",
    doi = "10.1164/rccm.200405-644st",
    openalex = "W4211194064",
    references = "doi101378chest1152462"
}

@article{doi101177000992280504400101,
    author = "Pelton, Stephen I. and Hammerschlag, Margaret R.",
    title = "Overcoming Current Obstacles in the Management of Bacterial Community-Acquired Pneumonia in Ambulatory Children",
    year = "2005",
    journal = "Clinical Pediatrics",
    url = "https://doi.org/10.1177/000992280504400101",
    doi = "10.1177/000992280504400101",
    openalex = "W2142695871",
    references = "nelson2000communityacquired"
}

Procalcitonin guidance substantially reduces antibiotic use in community-acquired pneumonia. These findings may have important clinical and public health implications.

@article{doi101164rccm2005121922oc,
    author = "Christ‐Crain, Mirjam and Stolz, Daiana and Bingisser, Roland and Müller, Christian and Miedinger, David and Huber, Peter and Zimmerli, Werner and Harbarth, Stephan and Tamm, Michael and Müller‐Stich, Beat P.",
    title = "Procalcitonin Guidance of Antibiotic Therapy in Community-acquired Pneumonia",
    year = "2006",
    journal = "American Journal of Respiratory and Critical Care Medicine",
    abstract = "Procalcitonin guidance substantially reduces antibiotic use in community-acquired pneumonia. These findings may have important clinical and public health implications.",
    url = "https://doi.org/10.1164/rccm.200512-1922oc",
    doi = "10.1164/rccm.200512-1922oc",
    openalex = "W2158000594",
    references = "doi101086380488"
}

@article{chetty2007management,
    author = "Chetty, Krishne and Thomson, Anne H",
    title = "Management of Community-Acquired Pneumonia in Children",
    year = "2007",
    journal = "Pediatric Drugs",
    url = "https://doi.org/10.2165/00148581-200709060-00007",
    doi = "10.2165/00148581-200709060-00007",
    number = "6",
    openalex = "W2069440405",
    pages = "401-411",
    volume = "9",
    references = "doi1010160007097184901104, doi101016s0140673605718778, doi101056nejm199708143370701, doi101056nejmra011994, doi101086313959, doi101086338460, doi101093oxfordjournalsajea116770, doi1010970000645420000400000006, doi1010970000645420020900000005, doi101542peds1134701"
}

priate starting point for consultation by specialists. Substantial overlap exists among the patients whom these guidelines address and those discussed in the recently published guidelines for health care-associated pneumonia (HCAP). Pneumonia in nonambulatory residents of nursing homes and other long-term care facilities epidemiologically mirrors hospital-acquired pneumonia and should be treated according to the HCAP guidelines. However, certain other patients whose conditions are included in the designation of HCAP are better served by management in accordance with CAP guidelines with concern for specific pathogens.

@article{doi101086511159,
    author = "Mandell, Lionel A. and Wunderink, Richard G. and Anzueto, Antonio and Bartlett, John G. and Campbell, G. Douglas and Dean, Nathan C. and Dowell, Scott F. and File, Thomas M. and Musher, Daniel M. and Niederman, Michael S. and Torres, Antoní and Whitney, Cynthia G.",
    title = "Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults",
    year = "2007",
    journal = "Clinical Infectious Diseases",
    abstract = "priate starting point for consultation by specialists. Substantial overlap exists among the patients whom these guidelines address and those discussed in the recently published guidelines for health care-associated pneumonia (HCAP). Pneumonia in nonambulatory residents of nursing homes and other long-term care facilities epidemiologically mirrors hospital-acquired pneumonia and should be treated according to the HCAP guidelines. However, certain other patients whose conditions are included in the designation of HCAP are better served by management in accordance with CAP guidelines with concern for specific pathogens.",
    url = "https://doi.org/10.1086/511159",
    doi = "10.1086/511159",
    openalex = "W2133979383",
    references = "bartlett1998communityacquired, doi101001jama282151458, doi101001jama2887862, doi101007s001340042210z, doi101056nejm199701233360402, doi101056nejm199907223410403, doi101056nejm200005043421801, doi101056nejm200103083441001, doi101056nejmoa011300, doi101086313954, doi101086380488, doi101093infdis1193317, doi101093infdis17511, doi101136thorax585377, doi101164rccm200405644st, doi101378chest1152462, flanders2004guidelines"
}

In admitted patients, non-adherence with the PSI admission guidelines was common. Compliance with scoring the PSI and its scoring accuracy was low. This may be due to a lack of awareness and its relative complexity. Further studies to identify potential barriers to compliance are warranted.

@article{doi101111j14401843200701121x,
    author = "Lee, Richard Wai Wing and Lindstrom, Steven",
    title = "A teaching hospital's experience applying the Pneumonia Severity Index and antibiotic guidelines in the management of community‐acquired pneumonia",
    year = "2007",
    journal = "Respirology",
    abstract = "In admitted patients, non-adherence with the PSI admission guidelines was common. Compliance with scoring the PSI and its scoring accuracy was low. This may be due to a lack of awareness and its relative complexity. Further studies to identify potential barriers to compliance are warranted.",
    url = "https://doi.org/10.1111/j.1440-1843.2007.01121.x",
    doi = "10.1111/j.1440-1843.2007.01121.x",
    openalex = "W1975808987",
    references = "flanders2004guidelines"
}

In patients with CAP, BNP levels are powerful and independent predictors of death and treatment failure. When used in conjunction with the PSI, BNP levels significantly improve the risk prediction when compared with the PSI alone.

@article{doi101111j13652796200801934x,
    author = "Christ‐Crain, Mirjam and Breidthardt, Tobias and Stolz, Daiana and Zobrist, K. and Bingisser, Roland and Miedinger, David and Leuppi, Jörg D. and Tamm, M. and Müeller, Beat and Mueller, Christian",
    title = "Use of B‐type natriuretic peptide in the risk stratification of community‐acquired pneumonia",
    year = "2008",
    journal = "Journal of Internal Medicine",
    abstract = "In patients with CAP, BNP levels are powerful and independent predictors of death and treatment failure. When used in conjunction with the PSI, BNP levels significantly improve the risk prediction when compared with the PSI alone.",
    url = "https://doi.org/10.1111/j.1365-2796.2008.01934.x",
    doi = "10.1111/j.1365-2796.2008.01934.x",
    openalex = "W1978824387",
    references = "niederman2001guidelines"
}

Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates.

@article{doi101086649554,
    author = "Solomkin, Joseph S. and Mazuski, John E. and Bradley, John S. and Rodvold, Keith A. and Goldstein, Ellie J. C. and Baron, Ellen Jo and O’Neill, Patrick J. and Chow, Anthony W. and Dellinger, E. Patchen and Eachempati, Soumitra R. and Gorbach, Sherwood L. and Hilfiker, Mary and May, Addison K. and Nathens, Avery B. and Sawyer, Robert G. and Bartlett, John G.",
    title = "Diagnosis and Management of Complicated Intra-abdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America",
    year = "2009",
    journal = "Clinical Infectious Diseases",
    abstract = "Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates.",
    url = "https://doi.org/10.1086/649554",
    doi = "10.1086/649554",
    openalex = "W2149186506",
    references = "doi101378chest1152462"
}

A summary of the initial management of patients admitted to hospital with suspected community acquired pneumonia (CAP) is presented in fig 8. Tables

@article{doi101136thx2009121434,
    author = "Lim, Wei Shen and Baudouin, Simon and George, Robert C. and Hill, Adam T. and Jamieson, C and Jeune, Ivan Le and Macfarlane, J T and Read, Robert C. and Roberts, Holly and Levy, Mark L and Wani, Manzoor A. and Woodhead, Mark",
    title = "BTS guidelines for the management of community acquired pneumonia in adults: update 2009",
    year = "2009",
    journal = "Thorax",
    abstract = "A summary of the initial management of patients admitted to hospital with suspected community acquired pneumonia (CAP) is presented in fig 8. Tables",
    url = "https://doi.org/10.1136/thx.2009.121434",
    doi = "10.1136/thx.2009.121434",
    openalex = "W2133440505",
    references = "doi1010160021968184901498, doi101056nejm199907223410403, doi101086313954, doi101086511159"
}

Radiographic pneumonia among children with wheezing is uncommon. Historical and clinical factors may be used to determine the need for chest radiography for wheezing children. The routine use of chest radiography for children with wheezing but without fever should be discouraged.

@article{doi101542peds20082062,
    author = "Mathews, Bonnie and Shah, Sonal and Cleveland, Robert and Lee, Edward Y. and Bachur, Richard G. and Neuman, Mark I.",
    title = "Clinical Predictors of Pneumonia Among Children With Wheezing",
    year = "2009",
    journal = "PEDIATRICS",
    abstract = "Radiographic pneumonia among children with wheezing is uncommon. Historical and clinical factors may be used to determine the need for chest radiography for wheezing children. The routine use of chest radiography for children with wheezing but without fever should be discouraged.",
    url = "https://doi.org/10.1542/peds.2008-2062",
    doi = "10.1542/peds.2008-2062",
    openalex = "W2111488225",
    references = "chetty2007management"
}

The most common causative bacteria were gram-negative organisms, which were highly sensitive to Meropenem, Imipenem and Amikacin, yet often treatable with more focused antibiotic coverage, which depended on the bacterium identified.

@article{doi101111j14401754201001814x,
    author = "Wang, Hua and Tang, Jun and Xiong, Ying and Li, Xihong and Gonzalez, Fernando F. and Mu, Dezhi",
    title = "Neonatal community‐acquired pneumonia: Pathogens and treatment",
    year = "2010",
    journal = "Journal of Paediatrics and Child Health",
    abstract = "The most common causative bacteria were gram-negative organisms, which were highly sensitive to Meropenem, Imipenem and Amikacin, yet often treatable with more focused antibiotic coverage, which depended on the bacterium identified.",
    url = "https://doi.org/10.1111/j.1440-1754.2010.01814.x",
    doi = "10.1111/j.1440-1754.2010.01814.x",
    openalex = "W1948980792",
    references = "chetty2007management"
}

It is difficult to determine the impact of community-acquired pneumonia (CAP) in Europe, because precise data are scarce. Mortality attributable to CAP varies widely between European countries and with the site of patient management. This review analysed the clinical and economic burden, aetiology and resistance patterns of CAP in European adults. All primary articles reporting studies in Europe published from January 1990 to December 2007 addressing the clinical and economic burden of CAP in adults were included. A total of 2606 records were used to identify primary studies. CAP incidence varied by country, age and gender, and was higher in individuals aged ≥65 years and in men. Streptococcus pneumoniae was the most common agent isolated. Mortality varied from <1% to 48% and was associated with advanced age, co-morbid conditions and CAP severity. Antibiotic resistance was seen in all pathogens associated with CAP. There was an increase in antibiotic-resistant strains, but resistance was not related to mortality. CAP was associated with high rates of hospitalisation and length of hospital stay. The review showed that the clinical and economic burden of CAP in Europe is high. CAP has considerable long-term effects on quality of life, and long-term prognosis is worse in patients with pneumococcal pneumonia.

@article{doi101136thx2009129502,
    author = "Welte, Tobias and Torres, Antoni and Nathwani, Dilip",
    title = "Clinical and economic burden of community-acquired pneumonia among adults in Europe",
    year = "2010",
    journal = "Thorax",
    abstract = "It is difficult to determine the impact of community-acquired pneumonia (CAP) in Europe, because precise data are scarce. Mortality attributable to CAP varies widely between European countries and with the site of patient management. This review analysed the clinical and economic burden, aetiology and resistance patterns of CAP in European adults. All primary articles reporting studies in Europe published from January 1990 to December 2007 addressing the clinical and economic burden of CAP in adults were included. A total of 2606 records were used to identify primary studies. CAP incidence varied by country, age and gender, and was higher in individuals aged ≥65 years and in men. Streptococcus pneumoniae was the most common agent isolated. Mortality varied from <1\% to 48\% and was associated with advanced age, co-morbid conditions and CAP severity. Antibiotic resistance was seen in all pathogens associated with CAP. There was an increase in antibiotic-resistant strains, but resistance was not related to mortality. CAP was associated with high rates of hospitalisation and length of hospital stay. The review showed that the clinical and economic burden of CAP in Europe is high. CAP has considerable long-term effects on quality of life, and long-term prognosis is worse in patients with pneumococcal pneumonia.",
    url = "https://doi.org/10.1136/thx.2009.129502",
    doi = "10.1136/thx.2009.129502",
    openalex = "W2135688996",
    references = "doi101086380488"
}

To determine the burden of community-acquired pneumonia (CAP) affecting adults in North America, a comprehensive literature review was conducted to examine the incidence, morbidity and mortality, etiology, antibiotic resistance, and economic impact of CAP in this population. In the United States, there were approximately 4.2 million ambulatory care visits for pneumonia in 2006. Pneumonia and influenza continue to be a common cause of death in the United States (ranked eighth) and Canada (ranked seventh). In 2005, there were >60,000 deaths due to pneumonia in persons aged>or=15 years in the United States alone. The hospitalization rate for all infectious diseases increased from 1525 hospitalizations per 100 000 persons in 1998 to 1667 per 100 000 persons in 2005. Admission to an intensive care unit was required in 10% to 20% of patients hospitalized with pneumonia. The mean length of stay for pneumonia was >or=5 days and the 30-day rehospitalization rate was as high as 20%. Mortality was highest for CAP patients who were hospitalized; the 30-day mortality rate was as high as 23%. All-cause mortality for CAP patients was as high as 28% within 1 year. Streptococcus pneumoniae continues to be the most frequently identified pathogen associated with CAP, and pneumococcal resistance to antimicrobials may make treatment more difficult. The economic burden associated with CAP remains substantial at >$17 billion annually in the United States. Despite the availability and widespread adherence to recommended treatment guidelines, CAP continues to present a significant burden in adults. Furthermore, given the aging population in North America, clinicians can expect to encounter an increasing number of adult patients with CAP. Given the significance of the disease burden, the potential benefit of pneumococcal vaccination in adults is substantial.

@article{doi103810pgm2010032130,
    author = "File, Thomas M. and Marrie, Thomas J.",
    title = "Burden of Community-Acquired Pneumonia in North American Adults",
    year = "2010",
    journal = "Postgraduate Medicine",
    abstract = "To determine the burden of community-acquired pneumonia (CAP) affecting adults in North America, a comprehensive literature review was conducted to examine the incidence, morbidity and mortality, etiology, antibiotic resistance, and economic impact of CAP in this population. In the United States, there were approximately 4.2 million ambulatory care visits for pneumonia in 2006. Pneumonia and influenza continue to be a common cause of death in the United States (ranked eighth) and Canada (ranked seventh). In 2005, there were >60,000 deaths due to pneumonia in persons aged>or=15 years in the United States alone. The hospitalization rate for all infectious diseases increased from 1525 hospitalizations per 100 000 persons in 1998 to 1667 per 100 000 persons in 2005. Admission to an intensive care unit was required in 10\% to 20\% of patients hospitalized with pneumonia. The mean length of stay for pneumonia was >or=5 days and the 30-day rehospitalization rate was as high as 20\%. Mortality was highest for CAP patients who were hospitalized; the 30-day mortality rate was as high as 23\%. All-cause mortality for CAP patients was as high as 28\% within 1 year. Streptococcus pneumoniae continues to be the most frequently identified pathogen associated with CAP, and pneumococcal resistance to antimicrobials may make treatment more difficult. The economic burden associated with CAP remains substantial at >$17 billion annually in the United States. Despite the availability and widespread adherence to recommended treatment guidelines, CAP continues to present a significant burden in adults. Furthermore, given the aging population in North America, clinicians can expect to encounter an increasing number of adult patients with CAP. Given the significance of the disease burden, the potential benefit of pneumococcal vaccination in adults is substantial.",
    url = "https://doi.org/10.3810/pgm.2010.03.2130",
    doi = "10.3810/pgm.2010.03.2130",
    openalex = "W2012617927",
    references = "doi101086313959"
}

@article{crossref2011bts,
    title = "BTS updates guidelines for community acquired pneumonia in children",
    year = "2011",
    journal = "PharmacoEconomics \& Outcomes News",
    url = "https://doi.org/10.2165/00151234-201106410-00005",
    doi = "10.2165/00151234-201106410-00005",
    number = "1",
    openalex = "W4211175334",
    pages = "3-3",
    volume = "641"
}

@article{doi101007s1009601112724,
    author = "Welte, Tobias",
    title = "Risk factors and severity scores in hospitalized patients with community-acquired pneumonia: prediction of severity and mortality",
    year = "2011",
    journal = "European Journal of Clinical Microbiology \& Infectious Diseases",
    url = "https://doi.org/10.1007/s10096-011-1272-4",
    doi = "10.1007/s10096-011-1272-4",
    openalex = "W2102647301",
    references = "crossref1998guidelines, niederman2001guidelines"
}

@article{doi101016jcell201110042,
    author = "Rechavi, Oded and Minevich, Gregory and Hobert, Oliver",
    title = "Transgenerational Inheritance of an Acquired Small RNA-Based Antiviral Response in C. elegans",
    year = "2011",
    journal = "Cell",
    url = "https://doi.org/10.1016/j.cell.2011.10.042",
    doi = "10.1016/j.cell.2011.10.042",
    openalex = "W2001603328"
}

Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

@article{doi101093cidcir531,
    author = "Bradley, John S. and Byington, Carrie L. and Shah, Samir S. and Alverson, Brian and Carter, Edward R. and Harrison, Christopher and Kaplan, Sheldon L. and Mace, Sharon E. and McCracken, George H. and Moore, Matthew R. and Peter, Shawn D. St. and Stockwell, Jana A. and Swanson, Jack",
    title = "The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America",
    year = "2011",
    journal = "Clinical Infectious Diseases",
    abstract = "Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.",
    url = "https://doi.org/10.1093/cid/cir531",
    doi = "10.1093/cid/cir531",
    openalex = "W2116581803",
    references = "doi101056nejm199512143332408, doi101056nejmra011994, doi101086511159, doi1010970000645420000400000006, doi1010970000645420020900000005, doi101542peds1134701"
}

The British Thoracic Society first published management guidelines for community acquired pneumonia in children in 2002 and covered available evidence to early 2000. These updated guidelines represent a review of new evidence since then and consensus clinical opinion where evidence was not found. This document incorporates material from the 2002 guidelines and supersedes the previous guideline document.

@article{doi101136thoraxjnl2011200598,
    author = "Harris, Michael J. and Clark, Julia and Coote, Nicole and Fletcher, Penny and Harnden, Anthony and McKean, Michael C and Thomson, Andrew R.",
    title = "British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011",
    year = "2011",
    journal = "Thorax",
    abstract = "The British Thoracic Society first published management guidelines for community acquired pneumonia in children in 2002 and covered available evidence to early 2000. These updated guidelines represent a review of new evidence since then and consensus clinical opinion where evidence was not found. This document incorporates material from the 2002 guidelines and supersedes the previous guideline document.",
    url = "https://doi.org/10.1136/thoraxjnl-2011-200598",
    doi = "10.1136/thoraxjnl-2011-200598",
    openalex = "W2147634646",
    references = "doi101086313954, doi1010970000645420000400000006, doi1010970000645420020900000005, doi101542peds1134701"
}

Tifacogin showed no mortality benefit in patients with sCAP despite evidence of biologic activity.

@article{doi101164rccm2010071167oc,
    author = "Wunderink, Richard G. and Laterre, Pierre-François and François, Bruno and Perrotin, D. and Artigas, Antonio and Vidal, Luis Otero and Lobo, Suzana M and Juan, Jorge San and Hwang, Sung Chul and Dugernier, Thierry and LaRosa, Steven P. and Wittebole, Xavier and Dhainaut, Jean-François and Doig, Christopher J. and Mendelson, Meryl H. and Zwingelstein, Christian and Su, Guoqin and Opal, Steven M.",
    title = "Recombinant Tissue Factor Pathway Inhibitor in Severe Community-acquired Pneumonia: A Randomized Trial",
    year = "2011",
    journal = "American Journal of Respiratory and Critical Care Medicine",
    abstract = "Tifacogin showed no mortality benefit in patients with sCAP despite evidence of biologic activity.",
    url = "https://doi.org/10.1164/rccm.201007-1167oc",
    doi = "10.1164/rccm.201007-1167oc",
    openalex = "W2141817221",
    references = "crossref1998guidelines"
}

The 5-day methylprednisolone therapy with imipenem was found effective in children having severe CAP. However, trials with larger cohorts are needed to study further beneficial effects of corticosteroids in children with CAP.

@article{doi101002ppul22574,
    author = "Nagy, Béla and Nagy, Béla and Gáspár, Imre and Papp, Ágnes Bali and Bene, Zsolt and Nagy, Béla and Nagy, Béla and Vokó, Zoltán and Balla, György",
    title = "Efficacy of methylprednisolone in children with severe community acquired pneumonia",
    year = "2012",
    journal = "Pediatric Pulmonology",
    abstract = "The 5-day methylprednisolone therapy with imipenem was found effective in children having severe CAP. However, trials with larger cohorts are needed to study further beneficial effects of corticosteroids in children with CAP.",
    url = "https://doi.org/10.1002/ppul.22574",
    doi = "10.1002/ppul.22574",
    openalex = "W1993234669",
    references = "chetty2007management"
}

@article{doi101007s101560120500x,
    author = "Morozumi, Miyuki and Chiba, Naoko and Ubukata, Kimiko and Okada, Takafumi and Sakata, Hiroshi and Matsubara, Keita and Iwata, Satoshi",
    title = "Antibiotic susceptibility in relation to genotype of Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae responsible for community-acquired pneumonia in children",
    year = "2012",
    journal = "Journal of Infection and Chemotherapy",
    url = "https://doi.org/10.1007/s10156-012-0500-x",
    doi = "10.1007/s10156-012-0500-x",
    openalex = "W1965495431",
    references = "chetty2007management"
}

The Dutch Working Party on Antibiotic Policy (SWAB) and the Dutch Association of Chest Physicians (NVALT) convened a joint committee to develop evidence-based guidelines on the diagnosis and treatment of community acquired pneumonia (CAP). The guidelines are intended for adult patients with CAP who present at the hospital and are treated as outpatients as well as for hospitalised patients up to 72 hours after admission. Areas covered include current patterns of epidemiology and antibiotic resistance of causative agents of CAP in the Netherlands, the possibility to predict the causative agent of CAP on the basis of clinical data at first presentation, risk factors associated with specific pathogens, the importance of the severity of disease upon presentation for choice of initial treatment, the role of rapid diagnostic tests in treatment decisions, the optimal initial empiric treatment and treatment when a specific pathogen has been identified, the timeframe in which the first dose of antibiotics should be given, optimal duration of antibiotic treatment and antibiotic switch from the intravenous to the oral route. Additional recommendations are made on the role of radiological investigations in the diagnostic work-up of patients with a clinical suspicion of CAP, on the potential benefit of adjunctive immunotherapy, and on the policy for patients with parapneumonic effusions.

@article{openalexw2107996101,
    author = "Wiersinga, W. Joost and Bonten, Marc J. M. and Boersma, Wim and Jonkers, René E. and Aleva, R M and Kullberg, Bart Jan and Schouten, Jeroen and Degener, J. E. and Janknegt, R. and Verheij, Theo and Sachs, A. P. E. and Prins, Jan M.",
    title = "SWAB/NVALT (Dutch Working Party on Antibiotic Policy and Dutch Association of Chest Physicians) guidelines on the management of community-acquired pneumonia in adults.",
    year = "2012",
    journal = "PubMed",
    abstract = "The Dutch Working Party on Antibiotic Policy (SWAB) and the Dutch Association of Chest Physicians (NVALT) convened a joint committee to develop evidence-based guidelines on the diagnosis and treatment of community acquired pneumonia (CAP). The guidelines are intended for adult patients with CAP who present at the hospital and are treated as outpatients as well as for hospitalised patients up to 72 hours after admission. Areas covered include current patterns of epidemiology and antibiotic resistance of causative agents of CAP in the Netherlands, the possibility to predict the causative agent of CAP on the basis of clinical data at first presentation, risk factors associated with specific pathogens, the importance of the severity of disease upon presentation for choice of initial treatment, the role of rapid diagnostic tests in treatment decisions, the optimal initial empiric treatment and treatment when a specific pathogen has been identified, the timeframe in which the first dose of antibiotics should be given, optimal duration of antibiotic treatment and antibiotic switch from the intravenous to the oral route. Additional recommendations are made on the role of radiological investigations in the diagnostic work-up of patients with a clinical suspicion of CAP, on the potential benefit of adjunctive immunotherapy, and on the policy for patients with parapneumonic effusions.",
    openalex = "W2107996101",
    references = "crossref1998guidelines"
}

@article{doi101096fj130101ufm,
    author = "Ptashne, Mark",
    title = "Faddish Stuff: Epigenetics and the Inheritance of Acquired Characteristics",
    year = "2013",
    journal = "The FASEB Journal",
    url = "https://doi.org/10.1096/fj.13-0101ufm",
    doi = "10.1096/fj.13-0101ufm",
    openalex = "W1993665072",
    references = "doi101016jcell200607024, doi101016jcell201110042, doi101016jcub200702030, doi101016jtig201106006, doi101038nature08533, doi101126science1134053, doi101126science1186777, doi101126science2414846, openalexw244629935, openalexw614012683"
}

A range of lifestyle factors and underlying medical conditions are associated with an increased risk of CAP in European adults. Understanding of the types of individual at greatest risk of CAP can help to ensure that interventions to reduce the risk of infection and burden of disease are targeted appropriately.

@article{doi101136thoraxjnl2013204282,
    author = "Torres, Antoní and Peetermans, Willy and Viegi, Giovanni and Blasi, Francesco",
    title = "Risk factors for community-acquired pneumonia in adults in Europe: a literature review",
    year = "2013",
    journal = "Thorax",
    abstract = "A range of lifestyle factors and underlying medical conditions are associated with an increased risk of CAP in European adults. Understanding of the types of individual at greatest risk of CAP can help to ensure that interventions to reduce the risk of infection and burden of disease are targeted appropriately.",
    url = "https://doi.org/10.1136/thoraxjnl-2013-204282",
    doi = "10.1136/thoraxjnl-2013-204282",
    openalex = "W2122415095",
    references = "doi1010160002934394900604"
}

We estimate and describe the incidence rates, mortality, and cost of CAP (community-acquired pneumonia), in both inpatient and outpatient settings, in the Czech Republic (CZ), Slovakia (SK), Poland (PL), and Hungary (HU). A retrospective analysis was conducted on administrative data from the health ministry and insurance reimbursement claims with a primary diagnosis of pneumonia in 2009 to determine hospitalization rates, costs, and mortality in adults ≥50 years of age. Patient chart reviews were conducted to estimate the number of outpatient cases. Among all adults ≥50 years, the incidence of hospitalized CAP per 100,000 person years was: 456.6 (CZ), 504.6 (SK), 363.9 (PL), and 845.3 (HU). The average fatality rate for all adults ≥50 is 19.1%, and for each country; 21.7% (CZ), 20.9% (SK), 18.6% (PL), 17.8% (HU). Incidence, fatality, and likelihood of hospitalization increased with advancing age. Total healthcare costs of CAP in EUR was 12,579,543 (CZ); 9,160,774 (SK); 22,409,085 (PL); and 18,298,449 (HU); with hospitalization representing over 90% of the direct costs of treatment. The burden of CAP increases with advancing age in four CEE countries, with hospitalizations driving the costs of CAP upwards in the elderly population. Mortality rates are generally higher than reported in Western EU countries.

@article{doi101371journalpone0071375,
    author = "Tichopád, Aleš and Roberts, Craig S. and Gembula, I. and Hájek, Petr and Skoczyńska, Anna and Hryniewicz, Waleria and Jahnz‐Różyk, Karina and Prymula, Roman and Solovič, Ivan and Kolek, Vı́tězslav",
    title = "Clinical and Economic Burden of Community-Acquired Pneumonia among Adults in the Czech Republic, Hungary, Poland and Slovakia",
    year = "2013",
    journal = "PLoS ONE",
    abstract = "We estimate and describe the incidence rates, mortality, and cost of CAP (community-acquired pneumonia), in both inpatient and outpatient settings, in the Czech Republic (CZ), Slovakia (SK), Poland (PL), and Hungary (HU). A retrospective analysis was conducted on administrative data from the health ministry and insurance reimbursement claims with a primary diagnosis of pneumonia in 2009 to determine hospitalization rates, costs, and mortality in adults ≥50 years of age. Patient chart reviews were conducted to estimate the number of outpatient cases. Among all adults ≥50 years, the incidence of hospitalized CAP per 100,000 person years was: 456.6 (CZ), 504.6 (SK), 363.9 (PL), and 845.3 (HU). The average fatality rate for all adults ≥50 is 19.1\%, and for each country; 21.7\% (CZ), 20.9\% (SK), 18.6\% (PL), 17.8\% (HU). Incidence, fatality, and likelihood of hospitalization increased with advancing age. Total healthcare costs of CAP in EUR was 12,579,543 (CZ); 9,160,774 (SK); 22,409,085 (PL); and 18,298,449 (HU); with hospitalization representing over 90\% of the direct costs of treatment. The burden of CAP increases with advancing age in four CEE countries, with hospitalizations driving the costs of CAP upwards in the elderly population. Mortality rates are generally higher than reported in Western EU countries.",
    url = "https://doi.org/10.1371/journal.pone.0071375",
    doi = "10.1371/journal.pone.0071375",
    openalex = "W2020787049",
    references = "crossref1998guidelines"
}

ABSTRACT Objectives: These guidelines update and extend evidence‐based indications for the management of children with acute gastroenteritis in Europe. Methods: The guideline development group formulated questions, identified data, and formulated recommendations. The latter were graded with the Muir Gray system and, in parallel, with the Grading of Recommendations, Assessment, Development and Evaluations system. Results: Gastroenteritis severity is linked to etiology, and rotavirus is the most severe infectious agent and is frequently associated with dehydration. Dehydration reflects severity and should be monitored by established score systems. Investigations are generally not needed. Oral rehydration with hypoosmolar solution is the major treatment and should start as soon as possible. Breast‐feeding should not be interrupted. Regular feeding should continue with no dietary changes including milk. Data suggest that in the hospital setting, in non–breast‐fed infants and young children, lactose‐free feeds can be considered in the management of gastroenteritis. Active therapy may reduce the duration and severity of diarrhea. Effective interventions include administration of specific probiotics such as Lactobacillus GG or Saccharomyces boulardii, diosmectite or racecadotril. Anti‐infectious drugs should be given in exceptional cases. Ondansetron is effective against vomiting, but its routine use requires safety clearance given the warning about severe cardiac effects. Hospitalization should generally be reserved for children requiring enteral/parenteral rehydration; most cases may be managed in an outpatients setting. Enteral rehydration is superior to intravenous rehydration. Ultrarapid schemes of intravenous rehydration are not superior to standard schemes and may be associated with higher readmission rates. Conclusions: Acute gastroenteritis is best managed using a few simple, well‐defined medical interventions.

@article{doi101097mpg0000000000000375,
    author = "Guarino, Alfredo and Ashkenazi, Shai and Gendrel, D and Vecchio, Andrea Lo and Shamir, Raanan and Szajewska, Hania",
    title = "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases Evidence‐Based Guidelines for the Management of Acute Gastroenteritis in Children in Europe",
    year = "2014",
    journal = "Journal of Pediatric Gastroenterology and Nutrition",
    abstract = "ABSTRACT Objectives: These guidelines update and extend evidence‐based indications for the management of children with acute gastroenteritis in Europe. Methods: The guideline development group formulated questions, identified data, and formulated recommendations. The latter were graded with the Muir Gray system and, in parallel, with the Grading of Recommendations, Assessment, Development and Evaluations system. Results: Gastroenteritis severity is linked to etiology, and rotavirus is the most severe infectious agent and is frequently associated with dehydration. Dehydration reflects severity and should be monitored by established score systems. Investigations are generally not needed. Oral rehydration with hypoosmolar solution is the major treatment and should start as soon as possible. Breast‐feeding should not be interrupted. Regular feeding should continue with no dietary changes including milk. Data suggest that in the hospital setting, in non–breast‐fed infants and young children, lactose‐free feeds can be considered in the management of gastroenteritis. Active therapy may reduce the duration and severity of diarrhea. Effective interventions include administration of specific probiotics such as Lactobacillus GG or Saccharomyces boulardii, diosmectite or racecadotril. Anti‐infectious drugs should be given in exceptional cases. Ondansetron is effective against vomiting, but its routine use requires safety clearance given the warning about severe cardiac effects. Hospitalization should generally be reserved for children requiring enteral/parenteral rehydration; most cases may be managed in an outpatients setting. Enteral rehydration is superior to intravenous rehydration. Ultrarapid schemes of intravenous rehydration are not superior to standard schemes and may be associated with higher readmission rates. Conclusions: Acute gastroenteritis is best managed using a few simple, well‐defined medical interventions.",
    url = "https://doi.org/10.1097/mpg.0000000000000375",
    doi = "10.1097/mpg.0000000000000375",
    openalex = "W2137535087",
    references = "doi101086318514"
}

The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia. (Funded by the Influenza Division of the National Center for Immunization and Respiratory Diseases.).

@article{doi101056nejmoa1405870,
    author = "Jain, Seema and Williams, Derek J. and Arnold, Sandra R. and Ampofo, Krow and Bramley, Anna M. and Reed, Carrie and Stockmann, Chris and Anderson, Evan J. and Grijalva, Carlos G. and Self, Wesley H. and Zhu, Yuwei and Patel, Anami and Hymas, Weston and Chappell, James D. and Kaufman, Robert A. and Kan, Jason and Dansie, David and Lenny, Noel and Hillyard, David R. and Haynes, Lia M. and Levine, Min Z. and Lindstrom, Stephen and Winchell, Jonas M. and Katz, Jacqueline M. and Erdman, Dean D. and Schneider, Eileen and Hicks, Lauri A. and Wunderink, Richard G. and Edwards, Kathryn M. and Pavia, Andrew T. and McCullers, Jonathan A. and Finelli, Lyn",
    title = "Community-Acquired Pneumonia Requiring Hospitalization among U.S. Children",
    year = "2015",
    journal = "New England Journal of Medicine",
    abstract = "The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia. (Funded by the Influenza Division of the National Center for Immunization and Respiratory Diseases.).",
    url = "https://doi.org/10.1056/nejmoa1405870",
    doi = "10.1056/nejmoa1405870",
    openalex = "W4239909494",
    references = "doi101542peds1134701"
}

The incidence of community-acquired pneumonia requiring hospitalization was highest among the oldest adults. Despite current diagnostic tests, no pathogen was detected in the majority of patients. Respiratory viruses were detected more frequently than bacteria. (Funded by the Influenza Division of the National Center for Immunizations and Respiratory Diseases.).

@article{doi101056nejmoa1500245,
    author = "Jain, Seema and Self, Wesley H. and Wunderink, Richard G. and Fakhran, Sherene and Balk, R.A. and Bramley, Anna M. and Reed, Carrie and Grijalva, Carlos G. and Anderson, Evan J. and Courtney, D. Mark and Chappell, James D. and Qi, Chao and Hart, Eric and Carroll, Frank E. and Trabue, Christopher and Donnelly, Helen K. and Williams, Derek J. and Zhu, Yuwei and Arnold, Sandra R. and Ampofo, Krow and Waterer, Grant and Levine, Min Z. and Lindstrom, Stephen and Winchell, Jonas M. and Katz, Jacqueline M. and Erdman, Dean D. and Schneider, Eileen and Hicks, Lauri A. and McCullers, Jonathan A. and Pavia, Andrew T. and Edwards, Kathryn M. and Finelli, Lyn",
    title = "Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults",
    year = "2015",
    journal = "New England Journal of Medicine",
    abstract = "The incidence of community-acquired pneumonia requiring hospitalization was highest among the oldest adults. Despite current diagnostic tests, no pathogen was detected in the majority of patients. Respiratory viruses were detected more frequently than bacteria. (Funded by the Influenza Division of the National Center for Immunizations and Respiratory Diseases.).",
    url = "https://doi.org/10.1056/nejmoa1500245",
    doi = "10.1056/nejmoa1500245",
    openalex = "W2000714505",
    references = "doi101086511159, doi101542peds1134701"
}

Adjunctive corticotherapy is associated with a reduction of length of stay, time to clinical stability, and severe complications among patients with CAP, but the effect on mortality remains uncertain.

@article{doi101371journalpone0144032,
    author = "Marti, Christophe and Grosgurin, Olivier and Harbarth, Stephan and Combescure, Christophe and Abbas, Mohamed and Rutschmann, Olivier and Perrier, Arnaud and Garin, Nicolas",
    title = "Adjunctive Corticotherapy for Community Acquired Pneumonia: A Systematic Review and Meta-Analysis",
    year = "2015",
    journal = "PLoS ONE",
    abstract = "Adjunctive corticotherapy is associated with a reduction of length of stay, time to clinical stability, and severe complications among patients with CAP, but the effect on mortality remains uncertain.",
    url = "https://doi.org/10.1371/journal.pone.0144032",
    doi = "10.1371/journal.pone.0144032",
    openalex = "W2194171205",
    references = "niederman2001guidelines"
}

@article{doi101038nrg2016106,
    author = "Chen, Qi and Yan, Wei and Duan, Enkui",
    title = "Epigenetic inheritance of acquired traits through sperm RNAs and sperm RNA modifications",
    year = "2016",
    journal = "Nature Reviews Genetics",
    url = "https://doi.org/10.1038/nrg.2016.106",
    doi = "10.1038/nrg.2016.106",
    openalex = "W2528415436",
    references = "doi101016jcell201406020, doi101146annurevge25120191000245"
}

It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia. The panel's recommendations for the diagnosis and treatment of HAP and VAP are based upon evidence derived from topic-specific systematic literature reviews.

@article{doi101093cidciw353,
    author = "Kalil, André C. and Metersky, Mark L. and Klompas, Michael and Muscedere, John and Sweeney, Daniel A. and Palmer, Lucy B. and Napolitano, Lena M. and O’Grady, Naomi P. and Bartlett, John G. and Carratalà, Jordi and Solh, Ali A. El and Ewig, Santiago and Fey, Paul D. and File, Thomas M. and Restrepo, Marcos I. and Roberts, Jason A. and Waterer, Grant and Cruse, Peggy and Knight, Shandra L. and Brożek, Jan",
    title = "Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society",
    year = "2016",
    journal = "Clinical Infectious Diseases",
    abstract = "It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia. The panel's recommendations for the diagnosis and treatment of HAP and VAP are based upon evidence derived from topic-specific systematic literature reviews.",
    url = "https://doi.org/10.1093/cid/ciw353",
    doi = "10.1093/cid/ciw353",
    openalex = "W2473016454",
    references = "doi101378chest12863854"
}

The Austrian biologist Paul Kammerer (1880-1926) would by now be long forgotten if Arthur Koestler had not published ‘The case of the Midwife toad’, in which he depicted Kammerer as a victim of the paradigm battle between neo-Darwinists and Lamarckists. Kammerer is still on the scientific agenda, with at least 10 publications since 2005. The question is still out if Kammerer fabricated his scientific results or not. In this paper we provide the evidence that Kammerer consistently faked experimental results. We show (1) that the design of his experiments could never have produced the results that he claimed, (2) that the assumptions he made about the developmental biology of the species he studied are falsified by recent research, and (3) that the specimens he showed as proof for the success of his experiments came from nature.

@article{doi1011631875986608504005,
    author = "van Alphen, J.J.M. and Arntzen, Jan W.",
    title = "Paul Kammerer and the inheritance of acquired characteristics",
    year = "2016",
    journal = "Contributions to Zoology",
    abstract = "The Austrian biologist Paul Kammerer (1880-1926) would by now be long forgotten if Arthur Koestler had not published ‘The case of the Midwife toad’, in which he depicted Kammerer as a victim of the paradigm battle between neo-Darwinists and Lamarckists. Kammerer is still on the scientific agenda, with at least 10 publications since 2005. The question is still out if Kammerer fabricated his scientific results or not. In this paper we provide the evidence that Kammerer consistently faked experimental results. We show (1) that the design of his experiments could never have produced the results that he claimed, (2) that the assumptions he made about the developmental biology of the species he studied are falsified by recent research, and (3) that the specimens he showed as proof for the success of his experiments came from nature.",
    url = "https://doi.org/10.1163/18759866-08504005",
    doi = "10.1163/18759866-08504005",
    openalex = "W2927588606",
    references = "doi102105ajph156549a"
}

Results from this meta-analysis suggested that adjunctive corticosteroids therapy was safe and beneficial for severe CAP. In addition, prolonged corticosteroids therapy was more effective. These results should be confirmed by adequately powered studies in the future.

@article{doi101371journalpone0165942,
    author = "Bi, Jirui and Yang, Jin and Wang, Ying and Yao, Cijiang and Jing, Mei and Liu, Ying and Cao, Jiyu and Lu, Youjin",
    title = "Efficacy and Safety of Adjunctive Corticosteroids Therapy for Severe Community-Acquired Pneumonia in Adults: An Updated Systematic Review and Meta-Analysis",
    year = "2016",
    journal = "PLoS ONE",
    abstract = "Results from this meta-analysis suggested that adjunctive corticosteroids therapy was safe and beneficial for severe CAP. In addition, prolonged corticosteroids therapy was more effective. These results should be confirmed by adequately powered studies in the future.",
    url = "https://doi.org/10.1371/journal.pone.0165942",
    doi = "10.1371/journal.pone.0165942",
    openalex = "W2555418995",
    references = "crossref1998guidelines"
}

In the present study, 50 nasopharyngeal swabs from children with community-acquired pneumonia (CAP) but negative for 18 common respiratory viruses, as measured by the Luminex xTAG Respiratory Viral Panel Assay, were subjected to multiplex metagenomic analyses using a next-generation sequencing platform. Taxonomic analysis showed that all sequence reads could be assigned to a specific species. An average of 95.13% were assigned to the Bacteria kingdom, whereas, only 0.72% were potentially virus derived. This snapshot of the respiratory tract virome revealed most viral reads to be respiratory tract related, classified into four known virus families: Paramyxoviridae, Herpesviridae, Anelloviridae, and Polyomaviridae. Importantly, we detected a novel human parainfluenza virus 3 (HPIV 3) strain with a 32-bp insertion in the haemagglutinin-neuraminidase (HN) gene that produced a negative result in the Luminex assay, highlighting the strength of virome metagenomic analysis to identify not only novel viruses but also viruses likely to be missed by ordinary clinical tests. Thus, virome metagenomic analysis could become a viable clinical diagnostic method.

@article{doi101002jmv24895,
    author = "Xu, Lili and Zhu, Yun and Ren, Xiang and Xu, Baoping and Liu, Chunyan and Xie, Zhengde and Shen, Kunling",
    title = "Characterization of the nasopharyngeal viral microbiome from children with community‐acquired pneumonia but negative for Luminex xTAG respiratory viral panel assay detection",
    year = "2017",
    journal = "Journal of Medical Virology",
    abstract = "In the present study, 50 nasopharyngeal swabs from children with community-acquired pneumonia (CAP) but negative for 18 common respiratory viruses, as measured by the Luminex xTAG Respiratory Viral Panel Assay, were subjected to multiplex metagenomic analyses using a next-generation sequencing platform. Taxonomic analysis showed that all sequence reads could be assigned to a specific species. An average of 95.13\% were assigned to the Bacteria kingdom, whereas, only 0.72\% were potentially virus derived. This snapshot of the respiratory tract virome revealed most viral reads to be respiratory tract related, classified into four known virus families: Paramyxoviridae, Herpesviridae, Anelloviridae, and Polyomaviridae. Importantly, we detected a novel human parainfluenza virus 3 (HPIV 3) strain with a 32-bp insertion in the haemagglutinin-neuraminidase (HN) gene that produced a negative result in the Luminex assay, highlighting the strength of virome metagenomic analysis to identify not only novel viruses but also viruses likely to be missed by ordinary clinical tests. Thus, virome metagenomic analysis could become a viable clinical diagnostic method.",
    url = "https://doi.org/10.1002/jmv.24895",
    doi = "10.1002/jmv.24895",
    openalex = "W2734170542",
    references = "nelson2000communityacquired"
}

Childhood community-acquired pneumonia (CAP) is a common illness; however, comprehensive studies of hospitalizations for CAP among children in China based on prospective and multicenter data collection are limited. The aim of this investigation was to determine the respiratory pathogens responsible for CAP in hospitalized children. From January to December 2015, oropharyngeal swabs and blood serum were collected from hospitalized children with CAP symptoms ranging in age from 6 months to 14 years at 10 hospitals across China. We used immunofluorescence to detect antibodies for eight respiratory viruses and passive agglutination to detect specific IgM against Mycoplasma pneumoniae (M. pneumoniae). Of 1500 children presenting with CAP, 691 (46.1%) tested positive for at least one pathogen (virus or M. pneumoniae). M. pneumoniae (32.4%) was detected most frequently, followed by respiratory syncytial virus (11.5%), adenovirus (5.0%), influenza A virus (4.1 %), influenza B virus (3.4%), parainfluenza virus types 2 and 3 type (3.1 %), parainfluenza virus type 1 (2.9%), and human metapneumovirus (0.3%). Co-infections were identified in 128 (18.5%) of the 691 cases. These data provide a better understanding of viral etiology and M. pneumoniae in CAP in children between 6 months and 14 years in China. More study of the etiologic investigations that would further aid the management of pneumonia is required. With effective immunization for RSV, ADV, and M. pneumoniae infections, more than one-half of the pneumonia cases in this study could have been prevented.

@article{doi101002jmv24963,
    author = "Hao, Ou-Mei and Xuefeng, Wang and Jian-ping, Liu and kunling, Shen and Ma, Rong and Zhenze, Cui and Deng, Li and Huimin, Yan and Lining, Wang and Zhaolan, Liu and Xin-min, LI and Xu, Hua and Jiang, Zhiyan and Li, Yanning and Yan, Huang and Baoqing, Zhang and Xiaochun, Feng and Chun-hui, HE and Jiang, Yonghong and Xue, Zhao and Wei, Wei and Wang, Zi",
    title = "Etiology of community‐acquired pneumonia in 1500 hospitalized children",
    year = "2017",
    journal = "Journal of Medical Virology",
    abstract = "Childhood community-acquired pneumonia (CAP) is a common illness; however, comprehensive studies of hospitalizations for CAP among children in China based on prospective and multicenter data collection are limited. The aim of this investigation was to determine the respiratory pathogens responsible for CAP in hospitalized children. From January to December 2015, oropharyngeal swabs and blood serum were collected from hospitalized children with CAP symptoms ranging in age from 6 months to 14 years at 10 hospitals across China. We used immunofluorescence to detect antibodies for eight respiratory viruses and passive agglutination to detect specific IgM against Mycoplasma pneumoniae (M. pneumoniae). Of 1500 children presenting with CAP, 691 (46.1\%) tested positive for at least one pathogen (virus or M. pneumoniae). M. pneumoniae (32.4\%) was detected most frequently, followed by respiratory syncytial virus (11.5\%), adenovirus (5.0\%), influenza A virus (4.1 \%), influenza B virus (3.4\%), parainfluenza virus types 2 and 3 type (3.1 \%), parainfluenza virus type 1 (2.9\%), and human metapneumovirus (0.3\%). Co-infections were identified in 128 (18.5\%) of the 691 cases. These data provide a better understanding of viral etiology and M. pneumoniae in CAP in children between 6 months and 14 years in China. More study of the etiologic investigations that would further aid the management of pneumonia is required. With effective immunization for RSV, ADV, and M. pneumoniae infections, more than one-half of the pneumonia cases in this study could have been prevented.",
    url = "https://doi.org/10.1002/jmv.24963",
    doi = "10.1002/jmv.24963",
    openalex = "W2763446670",
    references = "chetty2007management"
}

These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.

@article{doi101093cidcix669,
    author = "Shane, Andi L. and Mody, Rajal K. and Crump, John A. and Tarr, Phillip I. and Steiner, Theodore S. and Kotloff, Karen L. and Langley, Joanne M. and Wanke, Christine and Warren, Cirle A. and Cheng, Allen and Cantey, J. Robert and Pickering, Larry K.",
    title = "2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea",
    year = "2017",
    journal = "Clinical Infectious Diseases",
    abstract = "These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.",
    url = "https://doi.org/10.1093/cid/cix669",
    doi = "10.1093/cid/cix669",
    openalex = "W4254002263",
    references = "doi101086318514"
}

These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.

@article{doi101093cidcix959,
    author = "Shane, Andi L. and Mody, Rajal K. and Crump, John A. and Tarr, Phillip I. and Steiner, Theodore S. and Kotloff, Karen L. and Langley, Joanne M. and Wanke, Christine and Warren, Cirle A. and Cheng, Allen and Cantey, J. Robert and Pickering, Larry K.",
    title = "2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea",
    year = "2017",
    journal = "Clinical Infectious Diseases",
    abstract = "These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.",
    url = "https://doi.org/10.1093/cid/cix959",
    doi = "10.1093/cid/cix959",
    openalex = "W2766854211",
    references = "doi101086318514"
}

The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population-intervention-comparison-outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention.

@article{doi10118313993003005822017,
    author = "Torres, Antoní and Niederman, Michael S. and Chastre, Jean and Ewig, Santiago and Fernandez-Vandellos, Patricia and Hanberger, Håkan and Kollef, Marin H. and Bassi, Gianluigi Li and Luna, Carlos M. and Martín‐Loeches, Ignacio and Paiva, José Artur and Read, Robert C. and Rigau, David and Timsit, Jean‐François and Welte, Tobias and Wunderink, Richard G.",
    title = "International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia",
    year = "2017",
    journal = "European Respiratory Journal",
    abstract = "The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population-intervention-comparison-outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention.",
    url = "https://doi.org/10.1183/13993003.00582-2017",
    doi = "10.1183/13993003.00582-2017",
    openalex = "W2752537900",
    references = "doi101378chest1152462, doi101378chest12863854"
}

Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia. Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. Results: The panel addressed 16 specific areas for recommendations spanning questions of diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions. Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.

@article{doi101164rccm2019081581st,
    author = "Metlay, Joshua P. and Waterer, Grant and Long, Ann C. and Anzueto, Antonio and Brożek, Jan and Crothers, Kristina and Cooley, Laura A. and Dean, Nathan C. and Fine, Michael J. and Flanders, Scott A. and Griffin, Marie R. and Metersky, Mark L. and Musher, Daniel M. and Restrepo, Marcos I. and Whitney, Cynthia G.",
    title = "Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America",
    year = "2019",
    journal = "American Journal of Respiratory and Critical Care Medicine",
    abstract = "Background: This document provides evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia. Methods: A multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. Results: The panel addressed 16 specific areas for recommendations spanning questions of diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions. Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia.",
    url = "https://doi.org/10.1164/rccm.201908-1581st",
    doi = "10.1164/rccm.201908-1581st",
    openalex = "W2977322360",
    references = "doi101086511159, doi101378chest12863854"
}

@article{doi101016jprrv202201006,
    author = "Chee, Elyssa and Huang, Kathryn and Haggie, Stuart and Britton, Philip N",
    title = "Systematic review of clinical practice guidelines on the management of community acquired pneumonia in children",
    year = "2022",
    journal = "Paediatric Respiratory Reviews",
    url = "https://doi.org/10.1016/j.prrv.2022.01.006",
    doi = "10.1016/j.prrv.2022.01.006",
    openalex = "W4210459317",
    references = "chetty2007management"
}

The pneumonia is a significant public health issue because it raises the mortality and morbidity in people of all ages (2.56 million deaths worldwide each year) and has high medical and financial expenses. The two types of pneumonia i.e. community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). The incidences of multi-drug resistance in gram negative bacteria create difficulty in treatment and have negative effect on patients’ results. Antimicrobial resistance has also increased with passage of time. The goal of the current study was to describe microbial pneumonia with a focus on the pathogens’ etiology, pathogenicity, epidemiology, resistance pathways, diagnosis updates, and vaccine issues in order to address the issue before it has serious consequences. When choosing an antibiotic medication, clinicians face a significant challenge due to the emergence of novel illnesses, the increase in bacteria with multiple medication resistance, and germs that are challenging to cure. It is demonstrated that the effectiveness of first antimicrobial treatment is a critical issue for mortality in pneumonia, it is imperative to manage and effectively guide adequate antibiotic treatment. This requires the knowledge of engagement of the numerous pathogens in etiology of pneumonia. Additionally, until microbiological data are known and prompt de-escalation cannot be conducted; broad-spectrum antibiotic therapy may occasionally be administered. An overview of the epidemiology, resistance trends, microbiological etiology, and microbial diagnostics of pneumonia is given in this review.

@article{doi1054393pjhsv3i05229,
    author = "Adil, Muhammad Naveed and Royaidar, Jawad and Yassa, Ramy Rafaat Wadie and GonzagaLeong-on, Ma. Socorro and Iqbal, Faisal and Hussain, A. and Ali, Qamreen and Rasheed, Arsalan",
    title = "Epidemiology and Resistance Pattern In Microbial Pneumonia: A Review",
    year = "2022",
    journal = "Pakistan Journal of Health Sciences",
    abstract = "The pneumonia is a significant public health issue because it raises the mortality and morbidity in people of all ages (2.56 million deaths worldwide each year) and has high medical and financial expenses. The two types of pneumonia i.e. community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). The incidences of multi-drug resistance in gram negative bacteria create difficulty in treatment and have negative effect on patients’ results. Antimicrobial resistance has also increased with passage of time. The goal of the current study was to describe microbial pneumonia with a focus on the pathogens’ etiology, pathogenicity, epidemiology, resistance pathways, diagnosis updates, and vaccine issues in order to address the issue before it has serious consequences. When choosing an antibiotic medication, clinicians face a significant challenge due to the emergence of novel illnesses, the increase in bacteria with multiple medication resistance, and germs that are challenging to cure. It is demonstrated that the effectiveness of first antimicrobial treatment is a critical issue for mortality in pneumonia, it is imperative to manage and effectively guide adequate antibiotic treatment. This requires the knowledge of engagement of the numerous pathogens in etiology of pneumonia. Additionally, until microbiological data are known and prompt de-escalation cannot be conducted; broad-spectrum antibiotic therapy may occasionally be administered. An overview of the epidemiology, resistance trends, microbiological etiology, and microbial diagnostics of pneumonia is given in this review.",
    url = "https://doi.org/10.54393/pjhs.v3i05.229",
    doi = "10.54393/pjhs.v3i05.229",
    openalex = "W4308300430",
    references = "chetty2007management"
}