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In the Clinic |

Community-Acquired Pneumonia

Michael S. Niederman, MD
[+] Article, Author, and Disclosure Information

CME Objective: To review current evidence for prevention, diagnosis, treatment, and practice improvement of community-acquired pneumonia.

Funding Source: American College of Physicians.

Disclosures: Dr. Niederman, ACP Contributing Author, reports personal fees from Pfizer, personal fees from Thermo Fisher Scientific, grants and personal fees from Merck/Bayer, and personal fees from Cempra outside the submitted work. Disclosures can also be viewd at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0907

In the Clinic does not necessarily represent official ACP clinical policy. For ACP clinical guidelines, please go to https://www.acponline.org/clinical_information/guidelines/.

With the assistance of additional physician writers, the editors of Annals of Internal Medicine develop In the Clinic using MKSAP and other resources of the American College of Physicians.

Ann Intern Med. 2015;163(7):ITC1. doi:10.7326/AITC201510060
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This issue provides a clinical overview of community-acquired pneumonia, focusing on prevention, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.


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Recommended pneumococcal vaccine schedule and intervals, by age, health condition, and other risks.

The dashed line represents the interval between the two PPSV23 doses. PCV13 = 13-valent pneumococcal conjugate vaccine; PPSV23 = 23-valent pneumococcal polysaccharide vaccine.

* Immunocompromising conditions are defined as congenital or acquired immunodeficiency (including B- or T-lymphocyte deficiency, complement deficiencies, and phagocytic disorders excluding chronic granulomatous disease), HIV infection, chronic renal failure, nephrotic syndrome, leukemia, lymphoma, Hodgkin disease, generalized malignancy, multiple myeloma, solid organ transplant, and iatrogenic immunosuppression (including long-term systemic corticosteroids and radiation therapy).

† Anatomical or functional asplenia is defined as sickle cell disease and other hemoglobinopathies, congenital or acquired asplenia, splenic dysfunction, and splenectomy.

‡ Chronic health conditions are defined as chronic heart disease (including congestive heart failure and cardiomyopathies, excluding hypertension), chronic lung disease (including chronic obstructive lung disease, emphysema, and asthma), chronic liver disease (including cirrhosis), chronic alcoholism, or diabetes mellitus.

§ Administer PPSV23 as soon as possible if the 6- to 12-month time window has passed. Reproduced from Reference (3).

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