Health Care–Associated Pneumonia: Perception versus Reality

In this issue of Clinical Infectious Diseases, Dr Seymann et al [1] employed nine brief clinical case scenarios to ascertain the treatment practices of physicians for community-acquired pneumonia (CAP) and health care–associated pneumonia (HCAP). Using published treatment guidelines [2, 3] as the reference, the authors found that the majority of physicians were familiar with the treatment guidelines for both HCAP and CAP. However, they also observed that !10% of physicians prescribed antimicrobial regimens consistent with the guidelines for HCAP, whereas the majority prescribed regimens consistent with the CAP recommendations. These findings highlight the differences between perception and reality for the treatment of HCAP. The important implication of this observation is that there may be many patients with HCAP who are initially treated with an inappropriate antimicrobial regimen placing them at greater risk for mortality. Alternatively, this study may suggest that there are subcategories of HCAP for which treatment with broadspectrum antibiotics to cover potential