"Management of Community-Acquired Pneumonia in Immunocompromised Adults: A Consensus Statement Regarding Initial Strategies".

BACKGROUND: Community-acquired pneumonia (CAP) guidelines have improved the management and outcomes of patients with CAP, primarily by standardization of initial empiric therapy. But current society-published guidelines exclude immunocompromised patients.

RESEARCH QUESTION: There is no concensus regarding the initial management of immunocompromised patients with suspected CAP.

STUDY DESIGN AND METHODS: This consensus document was created by a multidisciplinary panel of 45 physicians with experience in the management of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus.

RESULTS: The panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiological work-up, general principles of empiric therapy, and empiric therapy for specific pathogens.

INTERPRETATION: This document offer general suggestions for the initial management of the immunocompromised patient who arrives at the hospital with pneumonia.