ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia
Issued Date
2023-01-01
Resource Type
ISSN
03424642
eISSN
14321238
Scopus ID
2-s2.0-85151405202
Journal Title
Intensive Care Medicine
Rights Holder(s)
SCOPUS
Bibliographic Citation
Intensive Care Medicine (2023)
Suggested Citation
Martin-Loeches I., Torres A., Nagavci B., Aliberti S., Antonelli M., Bassetti M., Bos L.D., Chalmers J.D., Derde L., de Waele J., Garnacho-Montero J., Kollef M., Luna C.M., Menendez R., Niederman M.S., Ponomarev D., Restrepo M.I., Rigau D., Schultz M.J., Weiss E., Welte T., Wunderink R. ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia. Intensive Care Medicine (2023). doi:10.1007/s00134-023-07033-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82712
Title
ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
University of Dundee School of Medicine
E.N. Meshalkin National Medical Research Center
IRCCS San Martino Polyclinic Hospital
Humanitas University
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Universitair Ziekenhuis Gent
University Medical Center Utrecht
Humanitas Research Hospital
Universitätsklinikum Freiburg
Hannover Medical School
Washington University School of Medicine in St. Louis
Weill Cornell Medical Center
University of Texas Health Science Center at San Antonio
University of Toronto
Northwestern University Feinberg School of Medicine
Trinity College Dublin
Hospital de La Santa Creu I Sant Pau
Nuffield Department of Medicine
Hôpital Beaujon
St James's Hospital
Hospital Universitario Virgen Macarena
Universitat de Barcelona
Universidad de Buenos Aires
Amsterdam UMC - University of Amsterdam
University of Dundee School of Medicine
E.N. Meshalkin National Medical Research Center
IRCCS San Martino Polyclinic Hospital
Humanitas University
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Universitair Ziekenhuis Gent
University Medical Center Utrecht
Humanitas Research Hospital
Universitätsklinikum Freiburg
Hannover Medical School
Washington University School of Medicine in St. Louis
Weill Cornell Medical Center
University of Texas Health Science Center at San Antonio
University of Toronto
Northwestern University Feinberg School of Medicine
Trinity College Dublin
Hospital de La Santa Creu I Sant Pau
Nuffield Department of Medicine
Hôpital Beaujon
St James's Hospital
Hospital Universitario Virgen Macarena
Universitat de Barcelona
Universidad de Buenos Aires
Amsterdam UMC - University of Amsterdam
Other Contributor(s)
Abstract
Purpose: Severe community-acquired pneumonia (sCAP) is associated with high morbidity and mortality, and whilst European and non-European guidelines are available for community-acquired pneumonia, there are no specific guidelines for sCAP. Methods: The European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and Latin American Thoracic Association (ALAT) launched a task force to develop the first international guidelines for sCAP. The panel comprised a total of 18 European and four non-European experts, as well as two methodologists. Eight clinical questions for sCAP diagnosis and treatment were chosen to be addressed. Systematic literature searches were performed in several databases. Meta-analyses were performed for evidence synthesis, whenever possible. The quality of evidence was assessed with GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Evidence to Decision frameworks were used to decide on the direction and strength of recommendations. Results: Recommendations issued were related to diagnosis, antibiotics, organ support, biomarkers and co-adjuvant therapy. After considering the confidence in effect estimates, the importance of outcomes studied, desirable and undesirable consequences of treatment, cost, feasibility, acceptability of the intervention and implications to health equity, recommendations were made for or against specific treatment interventions. Conclusions: In these international guidelines, ERS, ESICM, ESCMID, and ALAT provide evidence-based clinical practice recommendations for diagnosis, empirical treatment, and antibiotic therapy for sCAP, following the GRADE approach. Furthermore, current knowledge gaps have been highlighted and recommendations for future research have been made.