{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:57:43Z","timestamp":1790114263787,"version":"4.0.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Clinical practice guidelines profoundly influence patient care, making transparency, rigor, and fairness in their development essential. The 2025 community-acquired pneumonia (CAP) guideline update, developed by the American Thoracic Society (ATS) and initially co-sponsored by the Infectious Diseases Society of America (IDSA), included a recommendation to prescribe antibacterials for CAP upon detection of a respiratory viral pathogen. Here, we acknowledge the guidelines' strengths with respect to supporting shorter treatment duration but highlight the lack of supporting data for antibacterial therapy in CAP with a respiratory virus. We additionally reflect on shortcomings in the guideline development process itself, which may have led to this recommendation, including meeting logistics, communication, and methodology, using these observations to offer suggestions for future infectious diseases guidelines panels. Despite the unfortunate outcome, we commend IDSA for their difficult but principled decision to withdraw support, preserving stewardship priorities and the commitment to first do no harm.<\/jats:p>","DOI":"10.1093\/cid\/ciaf626","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:04:50Z","timestamp":1764248690000},"page":"625-629","source":"Crossref","is-referenced-by-count":4,"title":["We Dissent: Lessons From the 2025 Community-Acquired Pneumonia Guidelines"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4364-8141","authenticated-orcid":false,"given":"Leila S","family":"Hojat","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Disease, Emory University , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryrose R","family":"Laguio-Vila","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Disease, Rochester Regional Health System , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam R","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Infectious Disease, Corewell Health West Medical Group , Grand Rapids, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-7842","authenticated-orcid":false,"given":"Valerie M","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of General Internal Medicine, University of Utah , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"2026043013133173000_ciaf626-B1","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1164\/rccm.201908-1581ST","article-title":"Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America","volume":"200","author":"Metlay","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2026043013133173000_ciaf626-B2","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/S0140-6736(21)00313-5","article-title":"Discontinuing \u03b2-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial","volume":"397","author":"Dinh","year":"2021","journal-title":"Lancet"},{"key":"2026043013133173000_ciaf626-B3","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1001\/jamainternmed.2017.1938","article-title":"Association of adverse events with antibiotic use in hospitalized patients","volume":"177","author":"Tamma","year":"2017","journal-title":"JAMA Intern Med"},{"key":"2026043013133173000_ciaf626-B4","author":"World Health Organization"},{"key":"2026043013133173000_ciaf626-B5","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.chest.2022.01.053","article-title":"Influenza testing and treatment among patients hospitalized with community-acquired pneumonia","volume":"162","author":"Deshpande","year":"2022","journal-title":"Chest"},{"key":"2026043013133173000_ciaf626-B6","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1056\/NEJMoa2116846","article-title":"Early remdesivir to prevent progression to severe Covid-19 in outpatients","volume":"386","author":"Gottlieb","year":"2022","journal-title":"N Engl J Med"},{"key":"2026043013133173000_ciaf626-B7","doi-asserted-by":"crossref","first-page":"S167","DOI":"10.1093\/cid\/ciae511","article-title":"Remdesivir effectiveness in reducing the risk of 30-day readmission in vulnerable patients hospitalized for COVID-19: a retrospective US cohort study using propensity scores","volume":"79","author":"Mozaffari","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2026043013133173000_ciaf626-B8","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1513\/AnnalsATS.201809-646PS","article-title":"Improving sepsis treatment by embracing diagnostic uncertainty","volume":"16","author":"Prescott","year":"2019","journal-title":"Annals ATS"},{"key":"2026043013133173000_ciaf626-B9","doi-asserted-by":"crossref","first-page":"e2010700","DOI":"10.1001\/jamanetworkopen.2020.10700","article-title":"Prevalence of clinical signs within reference ranges among hospitalized patients prescribed antibiotics for pneumonia","volume":"3","author":"Klompas","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2026043013133173000_ciaf626-B10","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3390\/publications10030021","article-title":"Research questions with PICO: a universal mnemonic","volume":"10","author":"Nishikawa-Pacher","year":"2022","journal-title":"Publications"},{"key":"2026043013133173000_ciaf626-B11","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1109\/TPC.2012.2237253","article-title":"In-group (us) versus out-group (them) dynamics and effectiveness in partially distributed teams","volume":"56","author":"Privman","year":"2013","journal-title":"IEEE Trans Prof Commun"},{"key":"2026043013133173000_ciaf626-B12","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s10606-020-09385-x","article-title":"(Re)Configuring hybrid meetings: moving from user-centered design to meeting-centered design","volume":"29","author":"Saat\u00e7i","year":"2020","journal-title":"Comput Supported Coop Work"},{"key":"2026043013133173000_ciaf626-B13","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1177\/0272989X9101100302","article-title":"Do physicians have a bias toward action? A classic study revisited","volume":"11","author":"Ayanian","year":"1991","journal-title":"Med Decis Making"},{"key":"2026043013133173000_ciaf626-B14","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1164\/rccm.201705-0926OC","article-title":"A comparative analysis of pulmonary and critical care medicine guideline development methodologies","volume":"196","author":"Schoenberg","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2026043013133173000_ciaf626-B15","author":"Infectious Diseases Society of America (IDSA)"},{"key":"2026043013133173000_ciaf626-B16","doi-asserted-by":"crossref","first-page":"e2214153","DOI":"10.1001\/jamanetworkopen.2022.14153","article-title":"Association of inappropriate outpatient pediatric antibiotic prescriptions with adverse drug events and health care expenditures","volume":"5","author":"Butler","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026043013133173000_ciaf626-B17","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1093\/cid\/ciw118","article-title":"Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America","volume":"62","author":"Barlam","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2026043013133173000_ciaf626-B18","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jclinepi.2018.01.012","article-title":"GRADE guidelines: 18. How ROBINS-I and other tools to assess risk of bias in non-randomized studies should be used to rate the certainty of a body of evidence","volume":"111","author":"Sch\u00fcnemann","year":"2019","journal-title":"J Clin Epidemiol"},{"key":"2026043013133173000_ciaf626-B19","first-page":"133","article-title":"Which AI tools work best for research? Using librarian and student perspectives to inform a rating rubric","volume":"22","author":"Patterson","year":"2025","journal-title":"J Electron Resour Med Libr"},{"key":"2026043013133173000_ciaf626-B20","first-page":"56","article-title":"Can AI help with that? The limitations of AI tools for information discovery, search and reviews","volume":"22","author":"Patterson","year":"2025","journal-title":"J Electron Resour Med Libr"},{"key":"2026043013133173000_ciaf626-B21","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jclinepi.2021.02.026","article-title":"GRADE notes: how to use GRADE when there is \u201cno\u201d evidence? A case study of the expert evidence approach","volume":"137","author":"Mustafa","year":"2021","journal-title":"J Clin Epidemiol"},{"key":"2026043013133173000_ciaf626-B22","doi-asserted-by":"crossref","first-page":"l4606","DOI":"10.1136\/bmj.l4606","article-title":"Distinguishing opinion from evidence in guidelines","volume":"366","author":"Sch\u00fcnemann","year":"2019","journal-title":"BMJ"},{"key":"2026043013133173000_ciaf626-B23","author":"National Institute for Health and Care Excellence (NICE)"},{"key":"2026043013133173000_ciaf626-B24","author":"DIY Committee Guide"},{"key":"2026043013133173000_ciaf626-B25","doi-asserted-by":"crossref","first-page":"15593258211058339","DOI":"10.1177\/15593258211058339","article-title":"Ad hominem criticisms: an old trick to discredit inconvenient research. A response to Oakley et al. and the International Chiropractors Association Rapid Response Research Review Subcommittee","volume":"19","author":"C\u00f4t\u00e9","year":"2021","journal-title":"Dose Response"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf626\/65735510\/ciaf626.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/4\/625\/65735510\/ciaf626.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/4\/625\/65735510\/ciaf626.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:13:41Z","timestamp":1777569221000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/82\/4\/625\/8364680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,4]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12,4]]},"published-print":{"date-parts":[[2026,4,30]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf626","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4,15]]},"published":{"date-parts":[[2025,12,4]]}}}