CAP CLINICAL PATHWAY

INTENDED AUDIENCE:
Stewardship teams, including clinical infectious diseases physicians, pharmacists
and any medical practitioners involved in treatment decision-making for patients
with community-acquired pneumonia (CAP) are the intended audience of the
guidance.

HOW TO USE THIS CLINICAL PATHWAY:

The flowchart indicates actions to take and decision points in the clinical
workflow for diagnosis and treatment of patients with suspected community-
acquired pneumonia. Community-acquired pneumonia is pneumonia that
is acquired outside of the hospital setting. The clinical pathway presented
excludes immunocompromised patients defined as “inherited or acquired
immune deficiency or drug-induced neutropenia, including patients actively
receiving cancer chemotherapy, patients infected with HIV with suppressed CD4
counts, and solid organ or bone marrow transplant recipients”1. The pathway is
based on the ATS/IDSA Community-acquired Pneumonia Clinical Guidelines
(2019), however where appropriate, some clinical practice “enhancements” have
been included to reflect current best practices in CAP care.

IDSA DISCLAIMER:
This resource is intended to provide information on the management of patients
with community-acquired pneumonia. It is not intended to be inclusive of all
appropriate treatments or management approaches; to indicate the standard of
care or mandate any particular course of care; or to supplant clinician judgment
with respect to particular patients or clinical situations.

CONTENTS
Figure 1: Initial Evaluation and Treatment of Community-acquired Pneumonia........................................................................ 2
Table 1: Diagnosis of Community-acquired Pneumonia in Adults.................................................................................................... 3
Table 2: Criteria for Defining Severe Community-acquired Pneumonia........................................................................................ 3
Table 3: Diagnostic Testing for Community-acquired Pneumonia by Disease Severity.......................................................... 4
Table 4: Initial Treatment for Hospitalized Patients with Community-acquired Pneumonia................................................. 5
Table 5: Daily Follow-up Stewardship Considerations for Hospitalized Patients with Community-acquired
Pneumonia......................................................................................................................................................................................................... 6
References............................................................................................................................................................................................................. 7
Development and Conflict of Interest......................................................................................................................................................... 8

IDSA | CAP Clinical Pathway 1

 FIGURE 1: Initial Evaluation and Treatment of Community-Acquired Pneumonia (CAP)

Community-acquired pneumonia
(CAP) in adult patient without
immunocompromising condition
(Table 1)

Hypoxia OR NO Consider
criteria for outpatient
admission*? treatment

YES

Inpatient
admission

If viral dx Non-Severe Severe If viral dx

Antiviral therapy is Positive Diagnostic Diagnostic is Positive Antiviral therapy
if indicated. Testing, including CAP severity? Testing, including if indicated.
Consider viral diagnostics (Table 2) viral diagnostics Consider
antibiotic deferral if available if available antibiotic deferral
if low suspicion (Table 3) (Table 3) if low suspicion
of bacterial of bacterial
co-infection NO NO co-infection
e.g.. Procalcitonin e.g.. Procalcitonin
≤0.25 ‡ MRSA severe ≤0.25 ‡
CAP risk factors?
MRSA non-severe • Hospitalization and
CAP risk factors? parenteral antibiotics in the
YES YES
• MRSA colonization OR last 90 days OR
infection of the • History of MRSA colonization/
respiratory tract prior MRSA isolation,
especially from the
respiratory tract
Consider (within 1 year) Add
anti-MRSA anti-MRSA
NO NO
coverage coverage
(Table 4 (Table 4)
P. aeruginosa P. aeruginosa severe
non-severe CAP CAP risk factors?
risk factors? • Hospitalization and
• Advanced structural lung YES parenteral antibiotics in the
disease OR last 90 days OR
• History of P. aeruginosa • History of P. aeruginosa
colonization/infection colonization or infection of
within 1 year the respiratory tract

NO NO

β-lactam + macrolide (preferred) Anti-pseudomonal + β-lactam + macrolide (preferred)

OR respiratory fluoroquinolone atypical coverage OR β-lactam + respiratory
(Table 4) (Table 4) fluoroquinolone (Table 4)

Follow up
(Table 5)

*e.g. CURB-65, PSI

‡ This is a clinical practice enhancement to the ATS/IDSA CAP clinical practice guideline

IDSA | CAP Clinical Pathway 2

TABLE 1: Diagnosis of Community-acquired Pneumonia in Adults (≥ 18 years) Without
Immunocompromising Conditions1*

Newly recognized pulmonary infiltrate(s) on chest imaging†

AND at least one respiratory symptom
AND at least one other symptom/sign or finding (see below)
Respiratory Symptoms (at least one)
New or increased cough
New or increased sputum production
Dyspnea
Pleuritic chest pain
Other Signs or Findings (at least one)
Abnormal lung sounds (rhonchi or rales)
Fever (≥100.4 °F)
Leukocytosis or unexplained bandemia (above normal limits for laboratory)
Hypoxia (< 90%)
*Immunocompromising conditions include inherited or acquired immune deficiency or drug-induced neutropenia, including patients actively
receiving cancer chemotherapy, patients infected with HIV with suppressed CD4 counts, and solid organ or bone marrow transplant recipients.
†If clinical suspicion for community-acquired pneumonia is high despite negative chest radiograph, consider a CT scan of the chest.2

Return to Figure 1

TABLE 2: Criteria for Defining Severe Community-acquired Pneumonia1

One major criterion OR three or more minor criteria

Major Criteria Septic shock with need for vasopressors
Respiratory failure requiring mechanical ventilation
Minor Criteria Respiratory rate ≥ 30 breaths/min
PaO2/FIO2 ratio ≤ 250*
Multilobar (i.e., ≥ 2) infiltrates
Confusion/disorientation
Uremia (blood urea nitrogen level ≥ 20 mg/dl)
Leukopenia (white blood cell count < 4,000 cells/µl)†
Thrombocytopenia (platelet count < 100,000/µl)
Hypothermia (core temperature < 36oC)
Hypotension requiring aggressive fluid resuscitation
* PaO2 /FiO2 ratio is the ratio of patient’s oxygen in arterial blood (PaO2) to the fraction of the oxygen in the inspired air (FiO2).3
† Due to infection alone (i.e., not chemotherapy)

Return to Figure 1

IDSA | CAP Clinical Pathway 3

TABLE 3: Diagnostic Testing for Community-acquired Pneumonia (CAP) by Disease Severity1
Non-severe CAP* Severe CAP*
Blood
Blood culture Not routinely recommended† Yes
Procalcitonin ‡ Consider if available and Yes, if available and recommended
recommended by hospital guidelines by hospital guidelines
Respiratory
Respiratory culture Not routinely recommended unless: Yes
• hospitalization and parenteral
antibiotics in the last 90 days
OR
• anti-MRSA or anti – P. aeruginosa
coverage is intiated
OR
• advanced structural lung disease§
Molecular testing for Not routinely recommended† Yes, if available and recommended
bacterial pathogens ‡ by hospital guidelines
MRSA nasal swab (marker Yes, if: Yes, if
of MRSA colonization)* • hospitalization and parenteral • hospitalization and parenteral
antibiotics in the last 90 days antibiotics in the last 90 days
OR OR
• anti-MRSA coverage is intiated • history of MRSA colonization or
infection at any site within 1 year
OR
• anti-MRSA coverage is intiated
Viruses
Influenza testing Yes, if presence of virus in community, Yes, if presence of virus in community,
travel risk or potential exposure travel risk or potential exposure
COVID-19 testing ‡ Yes, if presence of virus in community, Yes, if presence of virus in community,
travel risk or potential exposure travel risk or potential exposure
Expanded viral molecular Consider if available† Yes, if available†
panel
(e.g., rhinovirus,
enterovirus, RSV) ‡
Urine
Legionella urine Yes, if recent outbreak, travel or Yes
antigen test other epidemiological factors
Pneumococcus urine Not routinely recommended† Yes
antigen test
* See table 3 for criteria for defining severe CAP
† Can be considered in select cases where timely pathogen determination may allow a more directed therapy or discontinuation of
unnecessary antibiotics
‡ This is a clinical practice enhancement to the ATS/IDSA CAP clinical practice guideline
§ Patients with advanced structural lung disease defined as “bronchiectasis, post-obstruction, advanced chronic obstructive pulmonary
disease or cystic fibrosis”
* See detailed note in Table 54

Return to Figure 1

IDSA | CAP Clinical Pathway 4

TABLE 4: Initial Treatment for Hospitalized Patients with Community-Acquired Pneumonia (CAP)
Stratified by Disease Severity and Risk for Antibiotic Resistant Pathogens1
(Note: Modify per hospital formulary and/or preferred antibiotics)

Allergy Alert‡: Use evidence-based validated risk strategies for evaluating β-lactam allergy and cross-reactivity to other β-lactams
(add references). Patients with mild to moderate penicillin reactions5 can typically tolerate non-pencillin β-lactams. Obtain a detailed
history as these patients may be de-labled based on tolerated penicillin-class agents since the initial reaction6. Patients with immediate
penicillin reactions (e.g., urticaria, angioedema, anaphylaxis) within 1 hour of β-lactam penicillin exposure may tolerate 3rd/4th generation
cephalosporins or carbapenems7. Avoid β-lactams in patients with severe delayed cutaneous reactions (e.g., Stevens-Johnson syndrome,
toxic epidermal necrolysis)8.
History
of MRSA
History of P. aeruginosa
colonization
Recent hospitalization and colonization or infection
or infection
Standard parenteral antibiotics at any site within 1 year
at any site
Regimen in the last 90 days within 1 year OR
OR Advanced structural
lung disease
MRSA nasal
PCR positive
β-lactam PLUS Atypical Coverage
MRSA Coverage β-lactam PLUS Atypical Coverage
(Preferred)
Choose One: Choose One: Choose One: Choose One: Choose One:
Ampicillin/ Azithromycin Vancomycin Piperacillin/ Azithromycin
sulbactam 500mg IV/PO per hospital tazobactam 4.5g 500mg IV/PO
1.5-3g IV q6h q24h* guidelines IV q6h q24h*
Non-severe CAP

Ceftriaxone Clarithromycin Linezolid Cefepime Clarithromycin

1-2g IV q24h (2g 500mg IV/PO 600 mg IV/PO 2g IV q8h 500mg IV/PO
if >80kg)9,10 q12h β-lactam PLUS Atypical Coverage Ceftazidime q12h
Doxycycline (same as standard regimen) 2g IV q8h Doxycycline
Cefotaxime
1-2g IV q8h 100mg IV/PO Imipenem 100mg IV/PO
q12h** 500mg IV q6h q12**
Meropenem Levofloxacin
Monotherapy (alternative if above
1000mg IV q8h 750mg IV/PO
regimen is not tolerated)
q24h
Choose One: Moxifloxacin
Levofloxacin 750mg IV/PO q24h 400mg
Moxifloxacin 400mg IV/PO q24h

β-lactam PLUS Atypical Coverage MRSA Coverage β-lactam PLUS Atypical Coverage MRSA Coverage β-lactam PLUS Atypical Coverage
Choose One: Choose One: Choose One: Choose One: Choose One: Choose One: Choose One: Choose One:
Ampicillin/ Azithromycin Vancomycin Piperacillin/ Azithromycin Vancomycin Piperacillin/ Azithromycin
sulbactam 500mg IV/PO per hospital tazobactam 4.5g 500mg IV/PO per hospital tazobactam 4.5g 500mg IV/PO
1.5-3g IV q6h q24h* guidelines IV q6h q24h* guidelines IV q6h q24h*
Ceftriaxone Clarithromycin Linezolid Cefepime Clarithromycin Linezolid Cefepime Clarithromycin
Severe CAP

2g IV q24h11,12‡ 500mg IV/PO 600 mg IV/PO 2g IV q8h 500mg IV/PO 600 mg IV/PO 2g IV q8h 500mg IV/PO
Cefotaxime q12h q12h Ceftazidime q12h q12h Ceftazidime q12h
1-2g IV q8h Doxycycline 2g IV q8h Doxycycline 2g IV q8h Doxycycline
100mg IV/PO Imipenem 100mg IV/PO Imipenem 100mg IV/PO
q12h** 500mg IV q6h q12** 500mg IV q6h q12**
Levofloxacin Meropenem Levofloxacin Meropenem Levofloxacin
750mg IV/PO 1000mg IV q8h 750mg IV/PO 1000mg IV q8h 750mg IV/PO
q24h q24h q24h
Moxifloxacin Moxifloxacin Moxifloxacin
400mg IV/PO 400mg IV/PO 400mg IV/PO
q24h q24h q24h

Severe CAP with allergy to β-lactams: Consider levofloxacin 750mg IV/PO q24h ± aztreonam 2g IV q8h +/- MRSA coverage

* Azithromycin 500mg q24 hours x 3 doses for 1500mg total to treat atypical pneumonia13,14
** Macrolide intolerance or QTc prolongation
‡ This is a clinical practice enhancement to the ATS/IDSA CAP clinical practice guideline

Notes:
• Antibiotic selections should be driven by local antibiograms
• Patients with septic shock should receive therapy per hospital sepsis guidelines
• Antibiotic dosing should be adjusted according to hospital guidelines and renal/liver insufficiency
• The following FDA-approved agents may be considered in non-severe CAP patients who are not candidates for β-lactams, macrolides or FQs: lefamulin 150 mg IV q 12
hours (600 mg orally q 12 h) or omadacycline 200 mg IV on day one followed by 100mg IV daily (300 mg orally q 12 h on day one, followed by 300 mg orally once daily)

Return to Figure 1

IDSA | CAP Clinical Pathway 5

 TABLE 5: Daily Follow-up Stewardship Considerations for Hospitalized Patients with
Community-acquired Pneumonia (CAP)‡
Assessment Action
Review clinical progression to confirm CAP (viral or bacterial) diagnosis vs.
non-infectious etiology
Evaluate documented penicillin allergy as recommended by hospital guidelines.
The evaluation may include history and physical examination, allergy consultation,
challenge doses, or skin testing (refer to top of Table 4).
Assess for clinical stability15, at least 5 clinical stability criteria (or return to baseline)
Confirm CAP below:
diagnosis and
assess clinical • Tmax ≤38ºC
improvement • HR ≤100
• RR ≤24
• Arterial O2 saturation ≥90% or pO2 >60mmHg
• Baseline mental status
• SBP ≥90 mmHg
Assess for CAP complications if no clinical improvement (secondary bacteremia, lung
abscess, or empyema)
Determine pathogen-directed therapy based on sputum culture (if sputum can be readily
produced) and other diagnostic testing
Viral diagnostics: Consider discontinuing antibiotic therapy if, viral diagnostics are
positive, Procalcitonin <0.25 (or 80% reduction on repeat testing in 72 hours),
WBC < 10,000 cells/µl, and low suspicion for bacterial co-infection
Diagnostic Testing
MRSA nasal swab:
• If negative, discontinue MRSA coverage (>95% negative predictive value in CAP)
• If positive, may not be indicative of MRSA pneumonia (<40% positive predictive value);
continue assessment of other MRSA risk factors and consider anti-MRSA therapy
discontinuation if no risk factors
Treatment Try to minimize broad spectrum antibiotics when possible
Considerations Assess for adverse drug events
Assess for clinical stability; patient afebrile with at least 5 signs of CAP stability criteria
listed above or return to baseline
Assess for ability to tolerate oral therapy, oral de-escalation options:
• No MDRO risk factors (choose one):
» Amoxicillin (500mg) + clavulanate (125mg) PO TID, or Amoxicillin
(875 mg or 2000mg) + clavulanate (125mg) PO BID
» Cefpodoxime 200mg PO BID
» Cefuroxime 500mg PO BID
• MDRO Risk Factors:
» Levofloxacin 750mg PO q24h
» If Legionella-negative or alternative etiology identified, discontinue
Discharge azithromycin after 1500mg total.
Considerations Consider duration of antibiotics administered (no more than 3-5 days total in the ED
and inpatient) if clinically stable by day 3.16‡
Ensure post-discharge follow-up including insurance coverage and availability at
outpatient pharmacy
Consider vaccination (pneumococcal, influenza, COVID-19, and RSV [in eligible
populations]). If relevant, provide smoking cessation counselling/medications and ensure
patient is on proper therapy to enhance control of chronic conditions (e.g., COPD, CHF)”
Educate patients and caregivers17:
• Planned antibiotic course (if needed) and instructions for follow-up medical care
• Signs and symptoms of worsening infection, and sepsis
• Signs and symptoms of antibiotic-associated adverse events, including Clostridioides
difficile infection
‡ This is a clinical practice enhancement to the ATS/IDSA CAP clinical practice guideline
Return to Figure 1

IDSA | CAP Clinical Pathway 6

 References
1
Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official
Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care
Med. 2019;200(7):e45-e67.
2
Ibrahim D, Bizri AR, El Amine MA, Halabi Z. Chest computed tomography and chest X-ray in the diagnosis of
community-acquired pneumonia: a retrospective observational study. J Int Med Res. 2021;49(8):3000605211039791.
doi:10.1177/03000605211039791
3
Diamond M, Peniston HL, Sanghavi D, Mahapatra S. Acute Respiratory Distress Syndrome. In: StatPearls. Treasure Island (FL):
StatPearls Publishing; November 9, 2021.
4
Dangerfield B, Chung A, et al. Predictive value of Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Swab PCR Assay
for MRSA Pneumonia. Antimicrob Agents Chemother. 2014 Feb; 58(2): 859–864.
5
Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review. JAMA. 2019 Jan
15;321(2):188-199. doi: 10.1001/jama.2018.19283. PMID: 30644987
6
Staicu ML, Jeffres MN, Jones BM, Stover KR, Wagner JL, Bland CM. Penicillin-allergy delabelling resources for clinicians
practicing in resource-limited settings: a full educational resource review of the grey literature. JAC Antimicrob Resist. 2023 Mar
20;5(2):dlad014. doi: 10.1093/jacamr/dlad014. PMID: 36949820; PMCID: PMC10026071.
7 Macy E, McCormick TA, Adams JL, Crawford WW, Nguyen MT, Hoang L, Eng V, Davis AC, McGlynn EA. Association Between
Removal of a Warning Against Cephalosporin Use in Patients With Penicillin Allergy and Antibiotic Prescribing. JAMA Netw
Open. 2021 Apr 1;4(4):e218367. doi: 10.1001/jamanetworkopen.2021.8367. PMID: 33914051; PMCID: PMC8085727.
8
Macy E, McCormick TA, Adams JL, Crawford WW, Nguyen MT, Hoang L, Eng V, Davis AC, McGlynn EA. Association Between
Removal of a Warning Against Cephalosporin Use in Patients With Penicillin Allergy and Antibiotic Prescribing. JAMA Netw
Open. 2021 Apr 1;4(4):e218367. doi: 10.1001/jamanetworkopen.2021.8367. PMID: 33914051; PMCID: PMC8085727.
9
Ackerman A, Zook NR, Siegrist JF, Brummitt CF, Cook MM, Dilworth TJ. Comparison of Clinical Outcomes among Intensive
Care Unit Patients Receiving One or Two Grams of Ceftriaxone Daily. Antimicrob Agents Chemother. 2020;64(6):e00066-20.
Published 2020 May 21. doi:10.1128/AAC.00066-20
10
Heffernan AJ, Curran RA, Denny KJ, et al. Ceftriaxone dosing in patients admitted from the emergency department with sepsis.
Eur J Clin Pharmacol. 2021;77(2):207-214. doi:10.1007/s00228-020-03001-z
11
Ackerman A, Zook NR, Siegrist JF, Brummitt CF, Cook MM, Dilworth TJ. Comparison of Clinical Outcomes among Intensive
Care Unit Patients Receiving One or Two Grams of Ceftriaxone Daily. Antimicrob Agents Chemother. 2020;64(6):e00066-20.
Published 2020 May 21. doi:10.1128/AAC.00066-20
12
Heffernan AJ, Curran RA, Denny KJ, et al. Ceftriaxone dosing in patients admitted from the emergency department with sepsis.
Eur J Clin Pharmacol. 2021;77(2):207-214. doi:10.1007/s00228-020-03001-z
13
Rizzato G, Montemurro L, Fraioli P, et al. Efficacy of a three day course of azithromycin in moderately severe community-
acquired pneumonia. Eur Respir J. 1995;8(3):398-402. doi:10.1183/09031936.95.08030398
14
Schönwald S, Skerk V, Petricevic I, Car V, Majerus-Misic L, Gunjaca M. Comparison of three-day and five-day courses of
azithromycin in the treatment of atypical pneumonia. Eur J Clin Microbiol Infect Dis. 1991;10(10):877-880. doi:10.1007/
BF01975847
15
Aliberti S, Zanaboni AM, Wiemken T, et al. Criteria for clinical stability in hospitalised patients with community-acquired
pneumonia. Eur Respir J. 2013;42(3):742-749.
16
Dinh A, Ropers J, Duran C, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired
pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial [published
correction appears in Lancet. 2021 Jun 5;397(10290):2150]. Lancet. 2021;397(10280):1195-1203.
17
Adapted from BAA-Hospital-Discharge-Flowchart-P.pdf (cdc.gov)

IDSA | CAP Clinical Pathway 7

Development and Conflict of Interest

FUNDING: This project was supported by the Centers for Disease Control and Prevention of the U.S.
Department of Health and Human Services (HHS) as part of a financial assistance award totaling
$219,765 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not
necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

CAP CLINICAL PATHWAY DEVELOPMENT GROUP:

Fritzie Albarillo, MD, Loyola University Medical Center; Edward Hines VA Center
Steve Burdette, MD, Wright State University
Shira Doron, MD, Tufts Medical Center
Thomas File, MD, Summa Health Medical Group
Kevin Hseuh, MD, Washington University School of Medicine
Maryrose Laguio-Vila, MD, Rochester Regional Hospital
Monica Mahoney, PharmD, Beth Israel Deaconness Medical Center
Jerod Nagel, PharmD, Michigan Medicine
Michael Pulia, MD, University of Wisconsin – Madison
Valerie Vaughn, MD, University of Utah; Salt Lake City VA

ACKNOWLEDGMENTS: We thank Ukwen Akpoji, PharmD and Snezana Naumovski, PharmD for their
contributions to the initial drafts of this clinical pathway.

CONFLICT OF INTEREST SUMMARY: The following list includes what has been reported to IDSA.
To provide thorough transparency, IDSA requires full disclosure of all relationships, regardless of
relevancy to the guidance topic. Evaluation of such relationships as potential conflicts of interest
is determined by a review process which includes assessment by the Board of Directors liaison to
the Standards and Practice Guidelines Committee and, if necessary, the Conflicts of Interest and
Ethics Committee. The assessment of disclosed relationships for possible conflicts of interests is
based on the relative weight of the financial relationship (i.e., monetary amount) and the relevance
of the relationship (i.e., the degree to which an association might reasonably be interpreted by an
independent observer as related to the topic or recommendation of consideration). IDSA requests
panel members to disclose activities and financial relationships/investments related to consultant/
advisory roles, promotional speakers bureau, stocks/bonds, honoraria, expert testimony, ownership
interest, research grants, organizational benefits, intellectual property, other numeration, activities
with other organizations, and relevant financial interest of family members. Readers of this clinical
pathway should be mindful of this when the list of disclosures is reviewed.
S.B. serves as a speaker for GlaxoSmithKline. F.A. has no disclosures. S.D. served as a speaker for
Vertex; served as an advisor for Sunovion. T.F. served as an advisor for Nabriva therapeutics; serves on
an Advisory Committee for ThermoFisher; serves as an advisor for HealthTrackRx; serves as an editor-
in-chief for Wolters Kluwer; serves as an author for Wolters Kluwer. K.H. serves as a fellowship program
director for IDSA; received a grant from CDC on behalf of their institution. M.L. has no disclosures.
J.N. has no disclosures. M.M. serves as an advisor and speaker for BD Biosciences; serves as an
advisor for Cidara; serves as an advisor for GlaxoSmithKline; received remuneration for research
conducted for Merck; served as an advisor for Pfizer; receives honoraria from ASHP; served as
immediate pas president of MSHP; serves on the editorial boards for ASHE, Contagion Live and OFID.
M.P. received a grant from AHRQ on behalf of their institution; received a grant from CDC on behalf
of their institution. V.V. received grants from CDC, GBMF, AHRQ, NAM on behalf of their institution;
received an individual grant from NHLBI.

IDSA | CAP Clinical Pathway 8