Guideline for Antibiotic Use in Adults with Community-acquired Pneumonia

Lee, Mi Suk; Oh, Jee Youn; Kang, Cheol-In; Kim, Eu Suk; Park, Sunghoon; Rhee, Chin Kook; Jung, Ji Ye; Jo, Kyung-Wook; Heo, Eun Young; Park, Dong-Ah; Suh, Gee Young; Kiem, Sungmin

A Legionella urinary antigen test is performed for patients with moderate or severe community-acquired pneumonia (level of recommendation: strong, level of evidence: moderate). The Legionella urinary antigen test is an appropriate testing method for patients hospitalized for idiopathic pneumonia, and is recommended in cases of moderate pneumonia, in cases where epidemiological evidence of the disease is available, and in cases of no response to β-lactam antibiotics [77] [78] [79] . The Legionella urinary antigen test has high sensitivity (~80%) and specificity (>95%) for diagnosing type 1 L. pneumophila infection [91] . The test gives positive results starting on the first day a disease occurs, and the positivity continues for several weeks [84] [85] [86] [87] [88] [89] [90] [91] [92] . The introduction of the Legionella urinary antigen test has enabled rapid diagnosis and treatment of Legionella in epidemic situations, and has improved treatment outcomes and fatality [93] . In another study, early diagnosis of Legionella infection using the Legionella urinary antigen test in patients with community-acquired pneumonia in non-epidemic situations, the test results positively affected the treatment of seven of nine patients who tested positive [94] .