Adjunctive and supportive measures for community-acquired pneumonia

The widespread introduction of penicillin in the 1940s resulted in a substantial reduction in mortality from community-acquired pneumonia (CAP). However, despite significant advances in medical science, only a small improvement has occurred since, particularly in patients with bacteremic pneumococcal pneumonia [1, 2]. Even modern intensive care has only made a small difference to the mortality in patients with severe pneumonia [3, 4]. While the aging population, increased number of patients with severe co-morbid illnesses, and the human immunodeficiency virus (HIV) epidemic have certainly contributed to the persistently high mortality rate [2, 5, 6], apparently healthy, immunocompetent patients continue to die from CAP. Disturbingly, a recent British Thoracic Society study concluded that no available therapy could substantially reduce the mortality rate from severe CAP in young adults [7].