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Updated: Aug 29, 2026

Experimental Model to Evaluate Resolution of Pneumonia
Published on: February 17, 2023
Radiographic resolution of community-acquired bacterial pneumonia in the elderly
Ali A El Solh1, Alan T Aquilina, Hakan Gunen
1Division of Pulmonary, Critical Care, and Sleep Medicine, University at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York, USA. solh@buffalo.edu
Objectives:
To investigate the radiographic clearance of proven community-acquired nontuberculous bacterial pneumonia in nonimmunocompromised older patients to provide working estimates of the rate of radiographic resolution as a function of the patient cumulative comorbidities, extent of initial radiographic involvement, functional status, and causative pathogens.
Design:
A prospective study.
Participants:
Seventy-four patients aged 70 and older, consecutively admitted to a hospital for community-acquired bacterial pneumonia.
Setting:
A university-affiliated teaching hospital.
Measurements:
Chest radiographs were performed every 3 weeks from the date of admission for a total period of 12 weeks or until all radiographic abnormalities had resolved or returned to baseline.
Results:
Sixty-four patients (86%) completed the study. The rate of radiographic clearance was estimated at 35.1% within 3 weeks, 60.2% within 6 weeks, and 84.2% within 12 weeks. Radiographic resolution was significantly slower for those with high comorbidity index, bacteremia, multilobar involvement, and enteric gram-negative bacilli pneumonias. Multivariate regression analysis demonstrated that the comorbidity index (relative risk for clearance=0.67 per class index, P<.001) and multilobar disease (relative risk for clearance=0.24 for more than one lobe, P<.001) had independent predictive value (Cox proportional hazards regression model) on the rate of resolution.
Conclusion:
The radiographic resolution of nontuberculous bacterial pneumonia in the elderly should take into account the extent of lobar disease and the burden of underlying illnesses. A waiting period of 12 to 14 weeks is recommended for slowly resolving pneumonia to be considered nonresolving.
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