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International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel

In 2019, the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) issued a substantial revision of the 2007 guideline on community-acquired pneumonia (CAP). Despite the fact that generalization of infectious disease guidelines is limited because of substantial geographic...

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Autores principales: Pletz, Mathias W., Blasi, Francesco, Chalmers, James D., Dela Cruz, Charles S., Feldman, Charles, Luna, Carlos M., Ramirez, Julio A., Shindo, Yuichiro, Stolz, Daiana, Torres, Antoni, Webb, Brandon, Welte, Tobias, Wunderink, Richard, Aliberti, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American College of Chest Physicians. Published by Elsevier Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445464/
https://www.ncbi.nlm.nih.gov/pubmed/32858009
http://dx.doi.org/10.1016/j.chest.2020.07.089
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author Pletz, Mathias W.
Blasi, Francesco
Chalmers, James D.
Dela Cruz, Charles S.
Feldman, Charles
Luna, Carlos M.
Ramirez, Julio A.
Shindo, Yuichiro
Stolz, Daiana
Torres, Antoni
Webb, Brandon
Welte, Tobias
Wunderink, Richard
Aliberti, Stefano
author_facet Pletz, Mathias W.
Blasi, Francesco
Chalmers, James D.
Dela Cruz, Charles S.
Feldman, Charles
Luna, Carlos M.
Ramirez, Julio A.
Shindo, Yuichiro
Stolz, Daiana
Torres, Antoni
Webb, Brandon
Welte, Tobias
Wunderink, Richard
Aliberti, Stefano
author_sort Pletz, Mathias W.
collection PubMed
description In 2019, the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) issued a substantial revision of the 2007 guideline on community-acquired pneumonia (CAP). Despite the fact that generalization of infectious disease guidelines is limited because of substantial geographic differences in microbiologic etiology and antimicrobial resistance, the ATS/IDSA guideline is frequently applied outside the United States. Therefore, this project aimed to give a perspective on the ATS/IDSA CAP recommendations related to the management of CAP outside the United States. For this, an expert panel composed of 14 international key opinion leaders in the field of CAP from 10 countries across five continents, who were not involved in producing the 2019 guideline, was asked to subjectively name the five most useful changes, the recommendation viewed most critically, and the recommendation that cannot be applied to their respective region. There was no formal consensus process, and the article reflects different opinions. Recommendations welcomed by most of the international pneumonia experts included the abandonment of the concept of “health-care-associated pneumonia,” the more restrictive indication for empiric macrolide treatment in outpatients, the increased emphasis on microbiologic diagnostics, and addressing the use of corticosteroids. Main criticisms included the somewhat arbitrary choice of a 25% resistance threshold for outpatient macrolide monotherapy. Experts from areas with elevated mycobacterial prevalence particularly opposed the recommendation of fluoroquinolones, even as an alternative.
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spelling pubmed-74454642020-08-26 International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel Pletz, Mathias W. Blasi, Francesco Chalmers, James D. Dela Cruz, Charles S. Feldman, Charles Luna, Carlos M. Ramirez, Julio A. Shindo, Yuichiro Stolz, Daiana Torres, Antoni Webb, Brandon Welte, Tobias Wunderink, Richard Aliberti, Stefano Chest Chest Infections: Special Features In 2019, the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) issued a substantial revision of the 2007 guideline on community-acquired pneumonia (CAP). Despite the fact that generalization of infectious disease guidelines is limited because of substantial geographic differences in microbiologic etiology and antimicrobial resistance, the ATS/IDSA guideline is frequently applied outside the United States. Therefore, this project aimed to give a perspective on the ATS/IDSA CAP recommendations related to the management of CAP outside the United States. For this, an expert panel composed of 14 international key opinion leaders in the field of CAP from 10 countries across five continents, who were not involved in producing the 2019 guideline, was asked to subjectively name the five most useful changes, the recommendation viewed most critically, and the recommendation that cannot be applied to their respective region. There was no formal consensus process, and the article reflects different opinions. Recommendations welcomed by most of the international pneumonia experts included the abandonment of the concept of “health-care-associated pneumonia,” the more restrictive indication for empiric macrolide treatment in outpatients, the increased emphasis on microbiologic diagnostics, and addressing the use of corticosteroids. Main criticisms included the somewhat arbitrary choice of a 25% resistance threshold for outpatient macrolide monotherapy. Experts from areas with elevated mycobacterial prevalence particularly opposed the recommendation of fluoroquinolones, even as an alternative. American College of Chest Physicians. Published by Elsevier Inc. 2020-11 2020-08-25 /pmc/articles/PMC7445464/ /pubmed/32858009 http://dx.doi.org/10.1016/j.chest.2020.07.089 Text en © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Chest Infections: Special Features
Pletz, Mathias W.
Blasi, Francesco
Chalmers, James D.
Dela Cruz, Charles S.
Feldman, Charles
Luna, Carlos M.
Ramirez, Julio A.
Shindo, Yuichiro
Stolz, Daiana
Torres, Antoni
Webb, Brandon
Welte, Tobias
Wunderink, Richard
Aliberti, Stefano
International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel
title International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel
title_full International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel
title_fullStr International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel
title_full_unstemmed International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel
title_short International Perspective on the New 2019 American Thoracic Society/Infectious Diseases Society of America Community-Acquired Pneumonia Guideline: A Critical Appraisal by a Global Expert Panel
title_sort international perspective on the new 2019 american thoracic society/infectious diseases society of america community-acquired pneumonia guideline: a critical appraisal by a global expert panel
topic Chest Infections: Special Features
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445464/
https://www.ncbi.nlm.nih.gov/pubmed/32858009
http://dx.doi.org/10.1016/j.chest.2020.07.089
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