When, where and how should a patient with community acquired pneumonia be admitted?

Community-acquired pneumonia is the leading cause of death (10-14%) from infectious disease and the source of many sepsis and septic shock cases attended in the emergency departments. There is great variability in the admission rates (22-61%), and 10-20% of such admissions have to be done in the intensive care unit. The correct determination of need for admission (when), admission site (where) and burden of delivered care (how) will determine the patient's prognosis, request for basic and microbiological studies, antibiotic regimen (via and duration), clinical follow-up intensity and, consequently, the use of socio-health resources (costs). This article aims to orient decision-making, taking into account the new trends in prognostic evaluation tendencies and the current alternatives to the classic hospital admission.