Rev Port Pneumol
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The diagnosis and treatment of Community Acquired Pneumonia (CAP) are controversial issues, without evidence of solid consensus, reflected in the proliferation of Clinical Practice Guidelines proposing a wide range of recommendations. The aim of this study was the clinical validation of five of the most widely recognized Clinical Practice Guidelines (published by the British Thoracic Society, American Thoracic Society, Infectious Diseases Society of America, European Respiratory Society and Portuguese Society of Pulmonology), in line with the real situation in Portugal, as well as an assessment of the role of macrolides in the treatment of CAP. This study adopted the Delphi method to reach consensus from a panel of 20 Portuguese experts in the treatment of CAP, 16 of which participated actively in the study. ⋯ The results of this study allowed the identification of the management options receiving a high level of acceptance among Portuguese physicians, as well as the estimation of epidemiological parameters, the definition of standards of care and the identification of the most relevant characteristics for the initial selection of antibiotics for empirical therapy. Erythromycin presents disadvantages in almost all characteristics, compared to advanced generation macrolides. Among these, azithromycin meets the panel of experts preferences as to antibiotic tolerability, administration schedule and costs better than clarithromycin.