Treatment Guidelines for Community-acquired Pneumonia in Korea: An Evidence-based Approach to Appropriate Antimicrobial Therapy

Jae-Hoon Song; Ki-Suck Jung

doi:10.5124/jkma.2010.53.1.20

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Song and Jung: Treatment Guidelines for Community-acquired Pneumonia in Korea: An Evidence-based Approach to Appropriate Antimicrobial Therapy

Focused Issue of This Month

Infectious Diseases during Winter Season and Related Policies for Their Control

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2010; 53(1): 20-42.

Published online: 31 January 2010

DOI: https://doi.org/10.5124/jkma.2010.53.1.20

Treatment Guidelines for Community-acquired Pneumonia in Korea: An Evidence-based Approach to Appropriate Antimicrobial Therapy

Jae-Hoon Song, MD¹, Ki-Suck Jung, MD²

¹Department of Internal Medicine, Sungkyunkwan University College of Medicine, Korea. songjh@skku.edu / jhsong@ansorp.org

²Department of Internal Medicine, Hallym University College of Medicine, Korea. pulmoks@hallym.ac.kr

Abstract

A successful therapy of community-acquired pneumonia requires appropriate empirical antimicrobial remedies. Etiology and antimicrobial susceptibility of major pathogens of pneumonia can differ by country. Therefore, an ideal treatment guideline of community-acquired pneumonia in a country should be based on the studies performed in individual countries. We have developed a treatment guideline for community-acquired pneumonia in immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.

Keywords: Pneumonia, Practice guideline, Anti-bacterial agents

Figures and Tables

Table 1

Grading levels of evidence

Table 2

Criteria for admission: Pneumonia Severity Index (PSI) score

^*Coexisting illness

- Neoplastic disease: within one year, excluding cutaneous basal cell carcinoma or cutaneous squamous cell carcinoma

- Liver disease: clinical or histological liver cirrhosis or chronic active hepatitis

- Congestive cardiac failure: diagnosed by history, physical examination or laboratory findings

- Cerebrovascular disease: clinical stroke or confirmed cases by CT or MRI

^†Altered mental state: disorientation to person, place and time; or recently decreased level of consciousness

Table 3

Expected mortality, risk, and recommended place for treatment according to PSI

Table 4

Expected mortality, risk, and recommended place for treatment according to PSI

Table 5

Criteria for severe pneumonia

Table 6

Checklist for decision of discharge

Table 7

Major pathogens of community-acquired pneumonia in Korea

Table 8

Etiologies according to severity

Table 9

Etiologies according to the risk factors

Table 10

Pathogen distribution of atypical pneumonia in Korea

ND: not done

Table 11

Etiology of viral pneumonia in Korea

^*Virus was isolated in 10.1% of community-acquired pneumonia

Table 12

Recommended antimicrobial therapy according to etiologic microorganism

FQ: fluoroquinolone

Table 13

Recommended dosage, merits and demerits^*

^*Antimicrobial agents recommended in empirical therapy were described. In general, dosages were based on the guidelines of Korea Food & Drug Administration.

Table 14

Causes of pneumonia with no response to antimicrobial therapy

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