Practical Insight into Understanding the Clinical Conundrum of Viral Community-acquired Pneumonia: A Review

Abstract

Introduction Viruses are a frequent cause of community-acquired pneumonia (CAP). Even after a viral pathogen has been identified, clinicians still must consider the possibility of bacterial co-infection and determine if antibiotic therapy is needed. This question, whether bacterial co-infection is present, becomes critical when considering optimal therapeutic management for patients with viral CAP. Methods A review was conducted of the epidemiology of viral CAP, reported rates of bacterial co-infections, antibiotic prescribing, and diagnostic and clinical methods for assessing risk of bacterial co-infection. Results Reported co-infection rates are variable, but evidence suggests bacterial co-infections are not documented in the majority of cases of viral CAP. Conclusions Practical research is needed to determine when antibiotics can be withheld or discontinued in patients with viral CAP in order to prevent harm associated with unnecessary antibiotic use.