Community-acquired pneumonia guidelines--an international comparison: a view from Europe

Following an outline that details the pathogens causing community-acquired pneumonia (CAP) identified in studies from Europe, this article reviews the guidelines for the management of CAP in four European countries--France, Italy, Spain, and the United Kingdom. The method behind the development of each document is described, followed by a comparison of the scope of each document. All four documents provide guidelines for the management of two groups of patients--the severely ill and the nonseverely ill patient. A penicillin or macrolide feature for the nonseverely ill and the combination of a third-generation cephalosporin plus a macrolide for the severely ill patient are described in all four guidelines. Despite their different origins and methods, these four guidelines have more similarities than differences--the latter serving to emphasize some of the areas that require further research in this important condition. An important area for research is the impact that these guidelines have on practice and especially on clinical outcomes.