What follow-up care is recommended for patients recovering from community-acquired pneumonia to prevent complications?

Follow-up care for patients recovering from community-acquired pneumonia (CAP) includes:

• Arrange a chest X-ray approximately 6 weeks after treatment completion for adults who have persistent symptoms or signs despite treatment, or who are at higher risk of underlying malignancy (especially smokers and those over 50 years old) to exclude complications or alternative diagnoses such as malignancy.
• Advise patients who smoke to stop smoking to reduce risk of further respiratory complications.
• Consider pneumococcal and seasonal influenza immunizations after recovery to prevent future infections.
• Reassess symptoms and clinical signs during follow-up, including using the CRB-65 score to evaluate severity and need for further intervention or hospital admission if deterioration occurs.
• Inform patients about the expected timeline of symptom resolution: fever should resolve by 1 week, chest pain and sputum production substantially reduce by 4 weeks, cough and breathlessness substantially reduce by 6 weeks, most symptoms resolve by 3 months though fatigue may persist, and full recovery is expected by 6 months.
• Advise patients to seek medical advice if symptoms worsen rapidly, do not improve as expected within 3 days of treatment, or if they become systemically very unwell.

This follow-up approach aims to detect and prevent complications such as unresolved infection, underlying malignancy, or other chronic respiratory conditions.

References: NICE CKS,NICE CG191