Community-acquired pneumonia: an unfinished battle

Community-acquired pneumonia remains a common illness with substantial morbidity and mortality. Current management challenges focus on identifying the likely etiologic pathogens based on an assessment of host risk factors, while attempting to make a specific etiologic diagnosis, which is often not possible. Therapy is necessarily empiric and focuses on pneumococcus and atypical pathogens for all patients, with consideration of other pathogens based on specific patient risk factors. It is important to understand the expected response to effective therapy, and to identify and manage clinical failure at the earliest possible time point. Prevention is focused on smoking cessation and vaccination against pneumococcus and influenza.