[Two guidelines on community-acquired pneumonia: both an important basis for individual policies]

Abstract

Recently, two Dutch guidelines were published regarding the management of patients with community-acquired pneumonia. In the Dutch Working Party on Antibiotic Policy (SWAB) guideline, the choice of antibiotic is based primarily on the severity of illness. In the Dutch Thoracic Society (NVALT) guideline, patients are differentiated for empiric therapy based on clinical and rapidly-available laboratory information, placing severely-ill patients in a separate category. Rapid tests for detection of Legionella pneumophila antigen have a prominent place in both guidelines. Contrary to the NVALT guideline, the SWAB guideline does not value Gram staining of sputum when selecting an initial therapeutic choice. The antibiotics recommended in the guidelines differ. Clinicians should take notice of both guidelines and take the best from each to formulate their own personal approach to patients with community-acquired pneumonia.