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CAP Guidelines 2010 Update
Philippine Clinical Practice Guidelineson the Diagnosis, EmpiricManagement, and Preventionof Community-acquired Pneumonia(CAP) in Immunocompetent Adults
2010 Update
Joint Statement of thePhilippine Society for Microbiology and Infectious DiseasesPhilippine College of Chest PhysiciansPhilippine Academy of Family PhysiciansPhilippine College of Radiology
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CAP Guidelines
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Manolito L. Chua, M.D. PSMID Chair Ma. Lourdes A. Villa, M.D. PSMID Rapporteur Marissa M. Alejandria, M.D. PSMID Member Abundio A. Balgos, M.D. PCCP Member Joselito R. Chavez, M.D. PCCP Member Vilma M. Co, M.D. PSMID Member Remedios F. Coronel, M.D. PSMID Member Jose Paolo M. De Castro, M.D. PAFP Member Raquel Victoria M. Ecarma, M.D. PSMID Member Benilda B. Galvez, M.D. PCCP Member Policarpio B. Joves, M.D. PAFP Member Isaias A. Lanzona, M.D. PCCP Member Myrna T. Mendoza, M.D. PSMID Member Leonardo Joseph Obusan, M.D. PCR Member Isabelita M. Samaniego, M.D. PAFP Member Ma. Bella R. Siasoco, M.D. PCCP Member Thelma E. Tupasi, M.D., FPSMID Adviser
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PSMID Angeles Tan-Alora, M.D.Mediadora C. Saniel, M.D.Thelma E. Tupasi, M.D.PCCP Roberto A. Barzaga, M.D.Teresita S. de Guia, M.D.Camilo C. Roa, Jr., M.D.PAFP Cynthia L. Hipol, M.D.Zorayda E. Leopando, M.D.Reynaldo A. Olazo, M.D.PCR Emmanuel D. Almasan, M.D.
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CAP Guidelines 2010 Update
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Foreword ............................................................................................. 6Methodology ........................................................................................ 7Introduction .......................................................................................... 10Executive Summary............................................................................. 11
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1. Can CAP be diagnosed accurately by history and physicalexamination? ............................................................................... 16Table 1. Accuracy of history and physical examinationfor the diagnosis of community-acquiredpneumonia .................................................................... 18Table 2. Accuracy of predicting pneumonia by physicians’clinical judgment ........................................................... 192. Is there any clinical feature that can predict CAP causedby an atypical pathogen? ............................................................. 19
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3. What is the value of the chest radiograph in the diagnosisof CAP? ........................................................................................ 244. What speci
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c views of chest radiograph should be requested?... 245. Are there characteristic radiographic features that canpredict the likely etiologic agent from the chest radiograph? ....... 256. How should a clinician interpret a radiographic
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ndingof “pneumonitis”?.......................................................................... 257. What is the signi
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cance of an initial “normal” chest radiographin a patient suspected to have CAP? ........................................... 268. Should a chest radiograph be repeated routinely? ...................... 269. What is the role of the chest CT scan in CAP? ............................ 26Table 3. Chest radiographic
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ndings which may predicta complicated course ................................................... 28
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10. Which patients will need hospital admission? .............................. 30Table 4. Clinical features of patients with community-acquired pneumonia according to risk categories ........ 31
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