June 2022

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June 2022 ◆ Volume 105, Number 6 www.aafp.org/afp American Family Physician 625 This article reviews the most recent evidence for the diagnosis and treatment of community- acquired pneumonia (CAP) in adults. As knowl- edge about COVID-19 increases, some of the fig- ures and recommendations presented here may change in the coming years. Epidemiology INCIDENCE • The annual incidence of CAP is 248 cases per 100,000 adults. However, this increases to 634 cases per 100,000 in adults 65 to 79 years of age and 16,430 cases per 100,000 in adults 80 years or older.1 • Hospitalization rates for CAP increase with advancing age.1-3 A systematic review of popula- tion-based studies found that the rate was 1,830 per 100,000 adults 65 years or older and 199 per 100,000 adults younger than 65 years.2 • The hospitalization rate for CAP is nine times higher in people with comorbid chronic obstruc- tive pulmonary disease.3 • Overall, the mortality rate for patients hos- pitalized with CAP is 6% at 30 days, even after initial clinical improvement. In hospitalized patients who do not improve initially or have unresolving pneumonia, the mortality rate is 34% at 30 days.4 • There are racial and ethnic di...