Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia

This clinical policy from the American College of Emergency Physicians is a revision of the 2009 "Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia." A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In the adult emergency department patient diagnosed with community-acquired pneumonia, what clinical decision aids can inform the determination of patient disposition? (2) In the adult emergency department patient with community-acquired pneumonia, what biomarkers can be used to direct initial antimicrobial therapy? (3) In the adult emergency department patient diagnosed with community-acquired pneumonia, does a single dose of parenteral antibiotics in the emergency department followed by oral treatment versus oral treatment alone improve outcomes? Evidence was graded and recommendations were made based on the strength of the available data.

The role of presepsin in the diagnosis of chronic obstructive pulmonary disease acute exacerbation with pneumonia

Aim: In this study, we aimed to investigate the role of presepsin in detecting concomitant pneumonia in patients presenting with acute exacerbation of chronic obstructive pulmonary disease (COPD) in the emergency department. Patients & methods: Three groups were formed in the study. Group 1: patients diagnosed with acute exacerbation of COPD; group 2: patients with acute exacerbation of COPD + pneumonia; group 3: healthy individuals. Results: Presepsin levels of the patients in group 2 were significantly higher than those of group 1 and group 3 (p < 0.05). There was a statistically significant difference in erythrocyte sedimentation rate, CRP, procalcitonin and presepsin values between two patient groups (p < 0.05). Conclusion: Presepsin can be used to diagnose pneumonia in patients with acute exacerbation of COPD admitted to the emergency department.