• Alfonsina Ruiz-Spinelli, Grant Waterer, and Jordi Rello.
• Intensive Care Unit, Department of Critical Care, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
• Curr Opin Crit Care. 2023 Oct 1; 29 (5): 400406400-406.

Purpose Of ReviewThe aim was to examine and summarize the most recent published literature in the last years stating the advances for treatment options and adjunctive therapies in patients hospitalized with severe community-acquired pneumonia (sCAP). Search was performed in PubMed, including observational studies, randomized controlled trials, systematic reviews and meta-analyses, and international guidelines.Recent FindingsRegardless of a large number of published CAP guidelines, most of their recommendations are based on low-level evidence.Viruses have an increasing role as sCAP etiology with an impact on mortality. Accordingly, it is imperative to strengthen the demand for vaccines and newer antivirals. Considering an early monitoring of the immune response in patients with severe Influenza, may help to evaluate a personalized immunomodulatory strategy. Despite growing evidence, the use of corticosteroids as an adjunctive therapy in bacterial sCAP continues to be controversial.SummaryMortality due to sCAP still remains undesirably high. This fact strengthens the need for more high-quality research to increase evidence. It also highlights the need for clinicians to be aware of the level of evidence of the stated recommendations, taking this into consideration before decision making.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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