CHEST Guidelines-Rebuttal-From-Dr-Pickens

Rebuttal-From-Dr-Pickens_chest

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The document presents a discussion between Dr. Chiagozie Pickens and Dr. Barbara E. Jones regarding the use of multiplex molecular testing in managing community-acquired pneumonia (CAP). Dr. Pickens highlights the importance of tailoring the use of these tests based on patient risk levels and clinical scenarios. He suggests that while stable, low-risk patients may not benefit significantly from lower respiratory tract (LRT) multiplex molecular tests, testing upper respiratory tract samples may yield benefits, such as antiviral therapy initiation or identifying public health threats like Legionella pneumophila. Dr. Pickens stresses the need for these tests to be part of a broader "CAP precision package," which includes other resources such as procalcitonin and antibiotic stewardship guidelines to optimize their use in clinical practice.<br /><br />Dr. Jones counters by questioning the routine use of multiplex molecular panels for all patients with CAP. Both physicians acknowledge the role of these panels but emphasize different applications, with both agreeing on the potential for multiplex molecular testing to support precision medicine in pneumonia.<br /><br />The document further includes financial disclosures and funding support mentions, noting that Dr. Pickens's institution received grants related to pneumonia research, and he serves on an editorial board for CHEST Infections. References highlight the exploration of various diagnostic tools and interventions to improve outcomes in pneumonia management.<br /><br />In summary, the document debates the appropriate application of multiplex molecular testing for pneumonia, suggesting personalized approaches based on patient risk factors and available resources to enhance antibiotic stewardship and timely treatment.

Keywords

multiplex molecular testing

community-acquired pneumonia

CAP

Dr. Chiagozie Pickens

Dr. Barbara E. Jones

precision medicine

antibiotic stewardship

procalcitonin

Legionella pneumophila

pneumonia management