Health care-associated pneumonia: an evidence-based review

Am J Med. 2011 Aug;124(8):689-97. doi: 10.1016/j.amjmed.2011.01.023. Epub 2011 Jun 12.


Health care-associated pneumonia is a relatively new classification of pneumonia that includes community-dwelling pneumonia patients having contact with the health care system. Current data indicate that health care-associated pneumonia patients present with more severe disease, are more likely to be infected with drug-resistant pathogens, and suffer increased mortality compared with community-acquired pneumonia patients. Guidelines recommend that these patients receive empiric antibiotics similar to those recommended for nosocomial pneumonia; however, it is not currently known if outcomes are improved when health care-associated pneumonia patients are treated with these therapies. In addition, the individual health care-associated pneumonia risk factors are based on limited data and are a poor predictor of patients likely to be infected with drug-resistant pathogens. Many questions remain on how to most appropriately care for this growing group of pneumonia patients. This review is an evidence-based discussion of current health care-associated pneumonia data, the individual health care-associated pneumonia risk factors, and limitations and additional considerations for the health care-associated pneumonia classification system.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Community-Acquired Infections / epidemiology
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology*
  • Cross Infection / etiology*
  • Delivery of Health Care*
  • Drug Resistance, Bacterial
  • Evidence-Based Medicine
  • Home Care Services
  • Homes for the Aged
  • Hospitalization
  • Humans
  • Immunosuppression / adverse effects
  • Nursing Homes
  • Patient Admission
  • Pneumonia / drug therapy
  • Pneumonia / epidemiology*
  • Pneumonia / etiology*
  • Pneumonia / microbiology
  • Renal Dialysis / adverse effects
  • Risk Factors