Decision
Evaluate for CAP major and minor criteria (Class III)
0 major or <3 minor criteria
1 major or >3 minor criteria
Background
2007 IDSA/ATS Criteria for Defining Severe Community-Acquired Pneumonia
Validated definition includes either 1 major criterion or ≥3 minor criteria
Minor Criterial
- Respiratory rate ≥30 breaths/min
- PaO2/FiO2 ratio ≤250
- Multi-lobar infiltrates
- Confusion/disorientation
- Uremia (blood urea nitrogen level ≥20 mg/dL)
- Leukopenia (white blood cell count <4000 cells/mcL, due to infection alone: ie, not chemotherapy induced)
- Thrombocytopenia (platelet count <100,000/mcL)
- Hypothermia (core temperature <36oC)
- Hypotension requiring aggressive fluid resuscitation
Major Criteria
- Septic shock with need for vasopressors
- Respiratory failure requiring mechanical ventilation
References
Abbreviations: ATS, American Thoracic Society; FiO2, fraction of inspired oxygen; IDSA, Infectious Diseases Society of America; PaO2, arterial oxygen pressure.
Reprinted with permission of the American Thoracic Society. Copyright © 2021 American Thoracic Society. All rights reserved. Metlay JP, Waterer GW, Long AC, et al. 2019. Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine. Volume 200, Issue 7, pages 45-67. The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.
