• Catia Cillóniz, Rok Civljak, Antonello Nicolini, and Antoni Torres.
• Department of Pneumology, Thorax Institute, Hospital Clinic of Barcelona-August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona (UB)-SGR 911-, Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.
• Respirology. 2016 Jan 1; 21 (1): 65-75.

AbstractPolymicrobial aetiology in community-acquired pneumonia (CAP) is more common than previously recognized. This growing new entity can influence inflammation, host immunity and disease outcomes in CAP patients. However, the true incidence is complicated to determine and probably underestimated due mainly to many cases going undetected, particularly in the outpatient setting, as the diagnostic yield is restricted by the sensitivity of currently available microbiologic tests and the ability to get certain types of clinical specimens. The observed rate of polymicrobial cases may also lead to new antibiotic therapy considerations. In this review, we discuss the pathogenesis, microbial interactions in pneumonia, epidemiology, biomarkers and antibiotic therapy for polymicrobial CAP. © 2015 Asian Pacific Society of Respirology.

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