Guidelines of the Paul-Ehrlich-Society of Chemotherapy, the German Respiratory Diseases Society, the German Infectious Diseases Society and of the Competence Network CAPNETZ for the Management of Lower Respiratory Tract Infections and Community-acquired Pneumonia

Update 2009 This summary of the update of the guidelines for the management of lower respiratory tract infections and community-acquired pneumonia (CAP) provides an overview on the structure and key points provided in this document. It is based on the structure of the Oxford Centre of Evidence Based Medicine. The update refers to important new insights from studies published by the CAPNETZ and the Bundesgeschäftsstelle für Qualitätssicherung (BQS). Essential new statements as compared to the original 2005 version include the following: 1) treatment of patients with acute exazerbation of COPD (restrictive indications for antimicrobial treatment); 2) preference for the CRB-65 score as tool for the validation of clinical assessment of pneumonia severity; 3) treatment of patients with mild CAP (oral cephalosporins no longer recommended); 4) treatment of patients with moderate CAP (ertapenem as new option in selected cases); 5) treatment of patients with severe CAP (antipseudomonal treatment only rarely indicated; reintroduction of aminoglycosides as agent in combination treatment); 6) reduction of treatment duration; 7) new focus on palliative treatment of patients with CAP.