• Julio A Ramirez, Daniel M Musher, Scott E Evans, Charles Dela Cruz, Kristina A Crothers, Chadi A Hage, Stefano Aliberti, Antonio Anzueto, Francisco Arancibia, Forest Arnold, Elie Azoulay, Francesco Blasi, Jose Bordon, Steven Burdette, Bin Cao, Rodrigo Cavallazzi, James Chalmers, Patrick Charles, Jean Chastre, Yann-Erick Claessens, Nathan Dean, Xavier Duval, Muriel Fartoukh, Charles Feldman, Thomas File, Filipe Froes, Stephen Furmanek, Martin Gnoni, Gustavo Lopardo, Carlos Luna, Takaya Maruyama, Rosario Menendez, Mark Metersky, Donna Mildvan, Eric Mortensen, Michael S Niederman, Mathias Pletz, Jordi Rello, Marcos I Restrepo, Yuichiro Shindo, Antoni Torres, Grant Waterer, Brandon Webb, Tobias Welte, Martin Witzenrath, and Richard Wunderink.
• Division of Infectious Diseases, University of Louisville, Louisville, KY. Electronic address: j.ramirez@louisville.edu.
• Chest. 2020 Nov 1; 158 (5): 1896-1911.

BackgroundCommunity-acquired pneumonia (CAP) guidelines have improved the treatment and outcomes of patients with CAP, primarily by standardization of initial empirical therapy. But current society-published guidelines exclude immunocompromised patients.Research QuestionThere is no consensus regarding the initial treatment of immunocompromised patients with suspected CAP.Study Design And MethodsThis consensus document was created by a multidisciplinary panel of 45 physicians with experience in the treatment of CAP in immunocompromised patients. The Delphi survey methodology was used to reach consensus.ResultsThe panel focused on 21 questions addressing initial management strategies. The panel achieved consensus in defining the population, site of care, likely pathogens, microbiologic workup, general principles of empirical therapy, and empirical therapy for specific pathogens.InterpretationThis document offers general suggestions for the initial treatment of the immunocompromised patient who arrives at the hospital with pneumonia.Copyright © 2020. Published by Elsevier Inc.

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