Community acquired pneumonia in Pakistan: an analysis on the literature published between 2003 and 2013

This article reviews literature pertaining to community acquired pneumonia (CAP) in adults published over the last decade (2003-2013) and includes ten studies and one guideline document. The review was done to identify the trend in etiologies and antimicrobial susceptibilities in order to recognize the need to update treatment guidelines for CAP in adults. Except for one laboratory based study, no articles were published between 2003 and 2008. Thereafter, most of the studies are retrospective in nature and published with a time lag hence reducing the relevance of the data. Out of the ten studies, two were purely clinical and among those that presented microbiological data, sensitivities to antibiotics were demonstrated in five studies which too were mainly organism specific. Streptococcus pneumonia remains the most common etiology of CAP in adults. There is increased isolation of atypical organisms in mild to moderate CAP, possibly due to better detection techniques. Mortality related to CAP is on the rise and noted up to 51% in patients with severe disease. There is limited evidence to support increasing resistances of pathogens to antibiotics. Lack of updated data leaves Pakistan Chest Society guidelines 2010 for treatment of CAP applicable to date in its original form. However there is a need to conduct more comprehensive studies on CAP to help reduce morbidity and mortality associated with the disease.