Wongsurakiat P, et al. - In this prospective observational analysis, researchers inquired about the prevalence and the influence of initial antibiotic selection on the results of patients with severe community-acquired pneumonia (CAP) who were admitted and managing in general wards. Patients that were hospitalized with CAP were 94 in total and of these, 50 (53.2%) were compatible with severe CAP. Significantly more positive blood culture was found in those with severe CAP vs those with non-severe CAP. The discordance of initial antibiotic treatment with the Infectious Diseases Society of America/American Thoracic Society guidelines was reported in 42% of all patients hospitalized with CAP, and 52% of patients with severe CAP. In patients with severe CAP, the independent risk factors of the unfavorable outcome, as identified in multivariate analysis, were age and initial antibiotic therapy discordant to guidelines for severe CAP in ICU. A lower number of hospital-free days were reported in those with unfavorable outcome vs those with favorable outcome. The identification of patients with severe CAP outside ICU for appropriate initial antibiotic selection to improve results was recommended.