CHAPTER 1: Introduction (principles for developing the guidelines)

Pneumonia is an important disease leading to high rates of both morbidity and mortality. However, treatment varies widely due to the variety of aetiological agents, facilities and physicians available for treatment, and antimicrobial agents. If these elements are integrated into a good methodology at a certain level, extremely effective guidelines could be established. In the 1990’s, guidelines for the diagnosis and treatment of pneumonia were released successively in the United States and Europe. In 1998, the Japanese Respiratory Society (JRS) decided to develop a series of ‘Guidelines for the Management of Respiratory Infections’ in Japan, and as an initial attempt in 2000 released ‘The guidelines for the management of community-acquired pneumonia in adults’. The guidelines had a great impact on the diagnosis and treatment, as well as on the research on pneumonia. The guidelines however, were not perfect, and it was therefore announced that they would be revised 3 years later. The present guidelines are the revised edition although released 2 years behind schedule. Since the original guidelines were published, the environment surrounding medical practice has been changing at a pace far greater than expected, and the concept of ‘Guidelines’ has become common practice and is widely accepted. The title has therefore been amended to ‘Guidelines for the Management of Community-Acquired Pneumonia in Adults’. Also, the contents of the guidelines have been greatly revised in light of further advancements in the diagnosis and treatment of pneumonia, criticisms of and opinions regarding the initial guidelines, research done since in accordance with the initial guidelines, and progress in the guidelines published in the US and Europe. Reflecting the fact that the former guidelines did not prevail well among physicians other than the JRS members, due consideration has been given to ensure these guidelines are delivered to all physicians nationwide. We hope the guidelines will be used with an understanding of the principles listed below. We also welcome the opinions and criticisms of the readers about these guidelines in order to update and improve them. This pocket-sized edition is a simplified leaflet that was prepared by collecting only the major tables and figures included in the “Guidelines for the Management of Community-Acquired Pneumonia in Adults” document. So, for details and references, please see the original guidelines (available only in Japanese). In this pocket-sized edition, you will find a mark of *, which denotes that the contents with such a mark are explained only in the original guidelines. This pocket-sized version was prepared with the intent of briefly summarizing the contents. Although these guidelines are a revised edition; however, it is undeniable that some aspects of the contents are still incomplete. Further amendment can be expected.