The current North American antibiotic guidelines for Community-Acquired Pneumonia in immunocompetent patients are from the Centers for Disease Control and Prevention (CDC), the Infectious Diseases Society of America (IDSA), the Canadian Infectious Disease Society / Canadian Thoracic Society (CIDS/CTS), and the American Thoracic Society (ATS). All four reflect that Streptococcus pneumoniae is the most common cause of CAP, that treatment that covers “atypical” pathogens (e.g., Legionella species, Chlamydia pneumoniae, Mycoplasma pneumoniae) can be associated with improved survival, and that the prevalence of antibiotic resistant S. pneumoniae is increasing. The CMS convened a conference of guideline authors, including Julie Gerberding, MD (CDC), John Bartlett, MD (IDSA), Ronald Grossman, MD (CIDS/CTS), and Michael Niederman, MD (ATS), to reach consensus on the antibiotic regimens that could be considered consistent with all four organizations’ guidelines. These regimens are reflected in this measure, and in the Pneumonia Antibiotic Consensus Recommendation located directly behind the measure information form.

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• American Thoracic Society
• National Institue of Allergy and Infectious Diseases - National Institutes of Health
• Centers for Disease Control and Prevention
• Infectious Disease Society of America

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• Bartlett JG, Dowell SF, Mandell LA, et al. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis. 2000;31:347-382.
• Butler JC, Hofmann J, Cetron MS, et al. The continued emergence of drug-resistant Streptococcus pneumonia in the United States: an update from the Centers for Disease Control and Prevention’s Pneumococcal Sentinel Surveillance System. J Infect Dis. 1996;174:986-993.
• Fine MJ, Smith MA, Carson CA, et al. Prognosis and outcomes of patients with community-acquired pneumonia. JAMA. 1996;275:134-141.
• Gleason PP, Meehan TP, Fine JM, et al. Associations between initial antimicrobial regimens and medical outcomes for elderly patients with pneumonia. Arch Intern Med. 1999;159:2562-2572.
• Heffelfinger JD, Dowell SF, Jorgensen JH, Klugman KP, et al. Management of Community-Acquired Pneumonia in the era of pneumococcal resistance: A Report From the Drug-Resistant Streptococcus pneumoniae Therapeutic Working Group. Archives of Internal Medicine. 2000, 160:1399-1408.
• Houck PM, MacLehose? RF, Niederman MS, Lowery JK. Empiric antibiotic therapy and mortality among Medicare pneumonia inpatients in 10 western states, 1993, 1995, and 1997. Chest. 2001;119;1420-1426.
• Niederman MS, Mandell LA, Anzueto A, et al. Guidelines for the management of adults with community-acquired pneumonia. American Thoracic Society. Am J Respir Crit Care Med. 2000;163:1730-1754.
• Mandell LA, Bartlett JG, Dowell SF, et al. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis. 2003;37:1405-1433.
• Mandell LA, Marrie TJ, Grossman RF, et al. Canadian guidelines for the initial management of community-acquired pneumonia: an evidence-based update by the Canadian Infectious Disease Society and the Canadian Thoracic Society. Clin Infect Dis. 2000;31:383-421.

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