MOST FORMS of bacterial pneumonia can be treated successfully at the present time. As a result, the mortality rate has declined from over 30% to less than 10% during the past two decades. However, deaths still occur frequently among small infants, in elderly persons, and in patients in whom treatment is not instituted early. Widespread use of antibiotics may have caused some reduction in the total incidence, but the number of cases of bacterial pneumonia has not declined in proportion to the striking decline in the mortality rate.1 Viral infections of the respiratory tract and other inciting factors which predispose to pneumonia have not been controlled.
In most instances, treatment must be started before a precise bacteriological diagnosis is made. It is usually possible to conclude that the patient has a bacterial rather than a viral pneumonia because of the sudden onset, pleuritic pain, and rusty sputum. There is usually