Adult Outpatients with Acute Cough due to Suspected Pneumonia or Influenza: CHEST Guideline and Expert Panel Report.

CONCLUSIONS: We suggest for outpatient adults with acute cough due to suspected pneumonia, the following clinical symptoms and signs are suggestive of pneumonia (cough, dyspnea, pleural pain, sweating/fevers/shivers, aches and pains, temperature 38°C or greater, tachypnea and new and localizing chest examination signs. Those suspected of having pneumonia, should have a chest radiograph to improve diagnostic accuracy. While the measurement of C-reactive protein strengthens both the diagnosis and exclusion of pneumonia, there was no added benefit of measuring procalcitonin in this setting. We suggest for outpatient adults with acute cough and suspected pneumonia, there is no need for routine microbiologic testing. For outpatient adults with acute cough, we suggest the use of empiric antibiotics as per local and national guidelines when pneumonia is suspected in settings where imaging cannot be obtained. Where there is no clinical or radiographic evidence of pneumonia, we suggest against the routine use of antibiotics. There is insufficient evidence to make recommendations for or against specific non-antibiotic symptomatic therapies. Finally, for outpatient adults with acute cough and suspected influenza, we suggest that initiating antiviral treatment (as per CDC advice) within 48 hours of symptoms could be associated with decreased antibiotic usage, hospitalization and improved outcomes. PMID: 30296418 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research