Treatment of Community-Acquired Pneumonia in Immunocompromised Adults: A Consensus Statement Regarding Initial Strategies

Chest. 2020 Nov;158(5):1896-1911. doi: 10.1016/j.chest.2020.05.598. Epub 2020 Jun 16.


Background: Community-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients.

Research question: There is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP.

Study design and methods: This consensus document was created by a multidisciplinary panel of 45 physicians with experience in the treatment of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus.

Results: The panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiologic workup, general principles of empirical therapy, and empirical therapy for specific pathogens.

Interpretation: This document offers general suggestions for the initial treatment of the immunocompromised patient who arrives at the hospital with pneumonia.

Keywords: community-acquired pneumonia; immunocompromised; pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Community-Acquired Infections* / microbiology
  • Community-Acquired Infections* / therapy
  • Consensus
  • Humans
  • Immunocompromised Host*
  • Patient Care Management* / methods
  • Patient Care Management* / standards
  • Pneumonia* / microbiology
  • Pneumonia* / therapy