Decisions about Treating Community-Acquired Pneumonia

Whether to treat a patient with community-acquiredpneumonia (CAP) as an outpatient or as an in-patient is an extremely important decision, yet admission rates vary considerably (1–3). The nature of investigational tests, the types and route of administration of drugs se-lected for treatment, and the cost of care all differ accord-ing to the site of care. Inpatient treatment costs are often 20 to 25 times greater than outpatient costs (4, 5). An estimated 4 million cases of CAP occur annually in the United States. These cases account for at least 600 000 hospital admissions and 64 million days of restricted activ-ity (6, 7). Eighty percent of patients with CAP are man-aged as outpatients. The remaining 20 % account for the lion’s share of the $8.5 billion to $10 billion spent annu-ally on the treatment of CAP. Outpatient management has certain advantages. Pa