Treatment of community acquired pneumonia

The S3 guidelines for diagnosis and therapy use German epidemiological data to set the standards for a risk and degree of severity based treatment of community acquired pneumonia (CAP). Over the last few years, a change in pathogen epidemiology has been recognized with the significance of staphylococci and enterobacteria increasing. CAP is becoming increasingly a disease of the elderly, for whom a more broadly effective initial therapy appears to be needed. Resistant pathogens play an important role in the course of the disease. For patients with a low risk of mortality, a reduction in the length of therapy seems possible. On the other hand, the early identification of critically ill patients who require treatment with high dose, broad spectrum antibiotics is necessary. Antibiotic associated diarrhoea, caused by Clostridium difficile, is a significant complication in antibiotic therapy. With the introduction of vaccination against Streptococcus pneumoniae for children, a change in the course of the illness and an improvement in the resistance situation has been achieved. An update of the S3 guidelines is intended for 2008 in order to integrate new knowledge into the recommendations.