Fast Five Quiz: Pneumonia Key Aspects

Michael Stuart Bronze, MD


March 23, 2020

The IDSA/ATS guidelines recommend testing adults with CAP for influenza, using a rapid influenza molecular assay (ie, influenza nucleic acid amplification test) over a rapid influenza diagnostic test (ie, antigen test) if influenza viruses are circulating in the community.

The IDSA/ATS guidelines also recommend against routinely obtaining sputum Gram stain and culture in adults with CAP who are managed in the outpatient setting. However, such testing is recommended in adults in the hospital setting who have severe CAP, adults who are being empirically treated for methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa, or adults who were hospitalized and received parenteral antibiotics in the past 90 days.

The IDSA/ATS guidelines also recommend against routinely obtaining blood cultures in adults with CAP managed in outpatient or hospital settings. The guidelines recommend that blood cultures be reserved for hospitalized adults with the same characteristics as described earlier for sputum Gram stain and culture testing.

Unless epidemiologic factors warrant or patients have severe CAP, the IDSA/ATS guidelines suggest not routinely testing urine for Legionella antigen in adults with CAP.

Read more about the workup of CAP.


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