CHEST Guidelines-Adult-Outpatients-With-Acute-Cough-Due-to-Suspecte

Adult-Outpatients-With-Acute-Cough-Due-to-Suspecte

Pdf Summary

The CHEST Guideline and Expert Panel Report outlines recommendations for managing adult outpatients with acute cough due to suspected pneumonia or influenza. The guideline emphasizes the frequent presentation of respiratory infections and the necessity for systematic investigation and treatment protocols.<br /><br />The report suggests certain clinical symptoms and signs that may indicate pneumonia, such as cough, dyspnea, pleural pain, and increased temperature (≥38°C). In suspected pneumonia cases, the report recommends chest radiography to enhance diagnostic precision, while routine procalcitonin measurement offers no significant benefit. Instead, employing C-reactive protein (CRP) levels can assist in diagnosing or ruling out pneumonia.<br /><br />For treatment, the panel advises against routine microbiological testing unless it may alter therapy. Empiric antibiotics should be used according to local and national guidelines in cases where imaging isn't possible, whereas antibiotics are not advised if there is no evidence of pneumonia.<br /><br />In addressing influenza, the guidelines recommend that antiviral treatment should commence within 48 hours of symptom onset to reduce antibiotic usage, hospitalizations, and improve patient outcomes. However, there isn’t enough robust evidence to advocate for or against specific non-antibiotic, symptomatic therapies.<br /><br />The guidelines emphasize the burden of pneumonia and influenza in terms of health impact and economic cost, noting their status as significant causes of infection-related deaths. The outlined approach is intended to streamline patient management in outpatient settings, ensuring that diagnosis and treatments are both evidence-informed and practical for clinical implementation.<br /><br />Lastly, the guideline identifies areas for further research including improving diagnostic algorithms and assessing the efficacy of non-antibiotic treatments, asserting the need for continued review and adaptation of treatment protocols based on emerging evidence.

Keywords

acute cough

pneumonia

influenza

respiratory infections

chest radiography

C-reactive protein

empiric antibiotics

antiviral treatment

outpatient management

treatment protocols