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Community acquired pneumonia has remained an important infection around the world where it accounts for substantial economic burden, mortality and morbidity. For example, in 2011 the average cost of medication for pneumonia was $66 while the cost of the emergency room consult for the pneumonia was $943 in the USA (Micek et al., 2014). The annual treatment cost in Europe for pneumonia is estimated to be above $10 billion. The mortality rate from pneumonia infection can be as high as 14% in a general population with the mortality in elderly reaching as high as 50% within the last five years. In the developed countries pneumonia is the main cause of death, where patients suffering from the disease are mainly managed in an outpatient setting. The mortality rate for the outpatient’s category of patients is less than 1% while that of the patients that require hospitalization is about 15% (Neiman et al., 2015).
Given that most of the patients suffering from pneumonia are managed by the health care center primary care and emergency physicians, the infectious diseases specialists lean towards seeing a population of patients that have pneumonia which is skewed toward more severe and complicated diseases (Nazarian et al., 2009). As a result, of this, the emergency physician can be less inclined to pursue the aggressive diagnostic cultures and testing except for the seriously injured patients as compared to the infectious diseases specialists (Welker et al., 2008). The management of pneumonia has remained fairly challenging due to several constantly changing factors that include changing the resistance of antibiotic, expanding pathogens spectrum, increasing cost effectiveness emphasis, and availability of newer antimicrobial agents (Yealy et al., 2004). Once pneumonia is diagnosed the main ED priority is to offer appropriate respiratory support examine the diseases severity, start necessarily empiric antibiotic therapy which is based on the most likely pathogens, and make decisions concerning the need for isolation and hospitalization (Torres et al., 1991).
Cause and Mechanism
Pneumonia results from infections that are primarily caused by viruses or bacteria and is less commonly caused by p