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Am Fam Physician. 2006;74(6):921

to the editor: In the article, “Diagnosis and Treatment of Community-Acquired Pneumonia,”1 the discussion of outpatient versus inpatient treatment did not list the absolute contraindications to outpatient treatment. These contraindications include: hypoxemia (oxygen saturation less than 90 percent while patient is breathing room air), hemodynamic instability, active coexisting condition requiring hospitalization, and inability to tolerate oral medications.2 When applying a clinical decision rule to an individual patient, it is imperative to recognize exclusion criteria to avoid misapplication of the rule.

editor’s note: This letter was sent to the authors of “Diagnosis and Treatment of Community-Acquired Pneumonia,” who declined to reply.

Email letter submissions to afplet@aafp.org. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. Letters submitted for publication in AFP must not be submitted to any other publication. Letters may be edited to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

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