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The Unintended, Negative Consequences of the Door-to-Antibiotic Measure for Pneumonia
TO THE EDITOR:
I read with interest the recent article by Wachter and colleagues (1). An additional consequence of policies from the Centers for Medicare & Medicaid Services (CMS) has been the disruption of local pneumonia guideline processes. The 2007 American Thoracic Society–Infectious Disease Society of America pneumonia guideline (2) recommended that “locally adapted guidelines should be implemented to improve process of care variables and relevant clinical outcomes.” In addition, “CAP [community-acquired pneumonia] guidelines should address a comprehensive set of elements in the process of care, rather than a single …
