Community-acquired bronchitis and pneumonia. Presentation, pathogens, and therapy

Community-acquired bronchitis and pneumonia are common conditions that can be approached in a methodical manner. Knowledge of the patient's epidemiologic history, any underlying conditions, and the clinical presentation should allow the physician to make a rational empirical judgment concerning therapy and the need for hospitalization. Most patients with bronchitis and many with pneumonia can be treated as outpatients if the diagnosis is certain and the patient is compliant and is not severely ill. However, if the diagnosis is in doubt or if other issues surface, strong consideration should be given to early hospitalization. All reasonable efforts should be made to identify a specific pathogen, although in many instances the clinician can make valid empirical choices, obviating invasive and potentially dangerous procedures. If the patient has an adverse drug reaction or otherwise responds unsatisfactorily to treatment, more invasive measures may be necessary.