Choosing Wisely:

Don’t order routine follow-up chest imaging for post-acute and long-term care residents with CAP whose symptoms have resolved within five to seven days.

Rationale and Comments: Radiographic findings tend to lag behind clinical response. Obtaining routine follow-up chest radiograph in patients with CAP who have responded to prescribed therapy is therefore not indicated and does not improve care outcomes. This approach is similar to that outlined by the American Thoracic Society and Infectious Diseases Society of America, both of whom recommend not obtaining a follow-up chest radiograph in patients whose symptoms have resolved within five to seven days.
Sponsoring Organizations:
  • Society for Post-Acute and Long-Term Care Medicine
  • Sources:
  • ATS/IDSA guideline
  • Disciplines:
  • Infectious disease
  • Pulmonary medicine
  • Geriatric Medicine
  • References: • Metlay JP, 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.
    • Bruns AH, et al. Patterns of resolution of chest radiograph abnormalities in adults hospitalized with severe community-acquired pneumonia. Clin Infect Dis. 2007;45(8):983-991.
    • Mittl RL Jr, et al. Radiographic resolution of community-acquired pneumonia. Am J Respir Crit Care Med. 1994;149(3 Pt 1):630-635.

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