Context

In 2022 a NICE surveillance report identified areas that required updating in NICE's guideline on pneumonia in adults (CG191), particularly around the inclusion of guidance for those under 18 who had been excluded. There were also 2 related NICE antimicrobial prescribing guidelines for both under and over 18s, on community-acquired and hospital-acquired pneumonia. This update amalgamates the antimicrobial prescribing guidelines with a partial update of CG191 to provide consolidated pneumonia recommendations.

The recommendations for pneumonia in children and adults provide guidance on a common respiratory infection that can have a considerable impact both on the individual and on healthcare provision and resources.

Community-acquired pneumonia has an annual incidence of 5 to 10 per 1,000 adult population, and accounts for 5% to 12% of all lower respiratory tract infections managed by GPs in the community. Between 22% and 42% of people with community-acquired pneumonia will require hospital-based care.

Hospital-acquired pneumonia occurs in around 0.5% to 2% of hospitalisations and is a common cause of morbidity and mortality. The presence of hospital-acquired pneumonia increases hospital stays by an average of 7 to 9 days per person and accounts for a large number of antibiotics prescribed.

Pneumonia accounts for 29,000 deaths per year in the UK, and 5% to 15% of people hospitalised with community-acquired pneumonia die within 30 days of admission, rising to 30% for those admitted to an intensive care unit.