NICE first published guidance on pneumonia in 2014, and updated 2019. At that time there was a push to use the CRB65 score in general practice and also CRP as an aid to deciding on when to use antibiotics. There was also excellent information on how long patients should expect symptoms to last for. I was also very surprised then – and still am – by the statistics behind pneumonia, so linked those in.
NICE has just published new guidance on the use of antibiotics in community acquired pneumonia. I am therefore updating this summary with that information. The most useful additional information from this is how long to use antibiotics for (i.e. most patients will need a five day course, but some will need longer).
NICE has also published new guidance on the use of antibiotics in hospital acquired pneumonia (i.e. that which starts 48 hrs or more after hospital admission). I have not included that in this summary as it is less useful for us. They do suggest considering following the community acquired pneumonia guidelines if the pneumonia is diagnosed between three and five days after admission.
The scale of the problem.
- 0.5 to 1% of adults are affected each year
- 5 to 12% of patients seen in GP with LRTI have pneumonia
- 22 to 42% of patients diagnosed are admitted to hospital
- 5 to 14% in hospital mortality
- 1.2 to 10% of those admitted end up on ITU
- More than half of deaths occur in those aged 84 and older