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Canadian Respiratory Journal
Volume 7, Issue 5, Pages 371-382

Summary of Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia: An Evidence-Based Update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society

Lionel A Mandell,1 Thomas J Marrie,2 Ronald F Grossman,3 Anthony W Chow,4 Robert H Hyland,5 and the Canadian CAP Working Group

1McMaster University, Hamilton, Ontario, Canada
2Dalhousie University, Halifax, Nova Scotia, Canada
3QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
4University of British Columbia, Vancouver, British Columbia, Canada
5St Michael’s Hospital, Toronto, Ontario, Canada

Copyright © 2000 Canadian Thoracic Society. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


Community-acquired pneumonia (CAP) is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in our knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity against Streptococcus pneumoniae has been important as well. It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Disease Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.