This National Institute for Health and Care Excellence (NICE) guideline covers diagnosing and managing community- and hospital-acquired pneumonia in adults. It aims to improve accurate assessment and diagnosis of pneumonia to help guide antibiotic prescribing and ensure that people receive the right treatment.
Every year between 0.5% and 1% of adults in the UK will have community‑acquired pneumonia. Between 1.2% and 10% of adults admitted to hospital with community‑acquired pneumonia are managed in an intensive care unit, and for these patients the risk of dying is more than 30%. More than half of pneumonia‑related deaths occur in people older than 84 years.
At any time 1.5% of hospital inpatients in England have a hospital‑acquired respiratory infection, more than half of which are hospital‑acquired pneumonia and are not associated with intubation. Hospital‑acquired pneumonia is estimated to increase hospital stay by about 8 days and has a reported mortality rate that ranges from 30–70%.
The guideline is needed because pneumonia is common and has a high mortality rate. The British Thoracic Society (2009) has published guidance on the management of community-acquired pneumonia in adults, but there is a lack of evidence‑based guidance on the management of hospital‑acquired pneumonia. For both types of pneumonia there is variation in care and areas of uncertainty for best practice, and these are the main focus of this guideline.
This guideline provides recommendations for the management of suspected and confirmed community‑ and hospital‑acquired pneumonia in adults. However, it does not provide recommendations on areas of care where best practice is already established, such as diagnosis using chest X‑ray.
This guideline does not cover:
You can read the guideline on NICE's website.