Clinical management of community-acquired pneumonia (CAP)--and Streptococcus pneumoniae infection in general--are controversial. Multiple sets of guidlines exist. This article reviews CAP, S. pneumoniae infection and drug resistance, the four sets of guidlines currently in use in North America, and the data upon which the agencies establishing those guidlines have based their consclusions, particularly about drug resistance and treatment failures. The article also considers the role of penicillin in the treatment of pneumococcal pneumonia.
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