Pneumonia: Bugs, Drugs, and Laboratory Duds

mTRODUCTION Jn 198'7 the Joint Com~i t t ee on Accreditation of Kealth~,sare Organizagons (JCABO) initiated core measures to evaluate the quality s f care for specific disease entities,l such as cs ty acquired pnessrnoBLaia (CAP). CAP is broadly de5ned by the InfecI;iwas Disease Society ofAmerica (DSA) as m acute infection sfthe pulmonav parenchyma, accompanied by the presence of an acute infiltrate on chest ra&ogxph or auscsalWy fmdngs "mica1 ofpnemoria. The IDS$%, also states that patients residing in an acute or c h o ~ c care facility are excluded Gom the diagnosis of CAP * The core measures set out by the JCAHO for CAP are oxygen assessment, pnemococcal vaccination screeing, blood culhxes, advice on smohqg cessation, md m~biotic a less than 8 hows~ ' review wrill discuss the eiiol0g-y of pneumonia, emergency depament (ED) evabdation, disposition, treatment options, and vaccHa"aa"isn. By reviewing the literatwe as it perbihs to pnewmonia, clinieims may decide for themselves whether to x!spt the core measures oxtEned by the JCAHO.