Guidelines
Community Acquired Pneumonia

Community Acquired Pneumonia

Initial Management

≥2 month old with suspected community acquired pneumonia (CAP)

  • <2 months old (see Fever & Sepsis in Neonate 0-28 Days Clinical Pathway, Fever & Sepsis in Infant 29-60 Days Clinical Pathway in Additional Resources below)
  • Signs of sepsis (see Septic Shock Clinical Pathway)
  • Immunocompromised
  • Cystic Fibrosis
  • Non-Cystic Fibrosis bronchiectasis
  • Primary Ciliary Dyskinesia/Immotile Cilia Syndrome
  • Sickle cell
  • Concern for tuberculosis
  • Tracheostomy in place
  • Hospital acquired pneumonia
  • Ventilator associated pneumonia
  • CXR
  • If moderate-large effusion: Consider obtaining ultrasound to evaluate for size of effusion and loculated/septated effusion
  • If under immunized for Hib (i.e., did not receive at least 2 doses of Hib vaccine), progression of CAP despite appropriate therapy, severely ill, or complicated CAP (i.e., large effusion, any size loculated/septated effusion, empyema, abscess, necrotic lung, pneumatocele):
    • Obtain CBC w diff, lytes, blood culture (aerobic), procalcitonin
    • For complicated CAP: add anaerobic blood cultures
  • Consider adding: MRSA nasal swab if concern for MRSA pneumonia (abscess, cavitation, empyema, or necrosis), viral testing if virus is circulating (influenza, SARS-CoV-2 PCR, RSV; BIOFIRE only if concerned for pertussis, atypical pneumonia, or if result would change antibiotic management; see Appendix A)

Note: If signs of sepsis, exit pathway and follow Septic Shock Clinical Pathway

Clinical Pathway

Has the CAP diagnosis been confirmed?

Additional Resources