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In 2005 the European Respiratory Society (ERS), in collaboration with The European Society for Clinical Microbiology and Infectious Diseases (ESCMID), published guidelines on the management of lower respiratory tract infections (LRTI) in adults [1]. This document was based on published scientific literature up to the end of 2002. We have now updated these guidelines to include publications to May 2010. The Taskforce responsible for guideline development has been sponsored by the ERS and ESCMID. Members of the Taskforce are members of the sponsoring ERS and/or ESCMID.

Our objective is to provide evidence-based recommendations for the most common management questions occurring in routine clinical practice in the management of adult patients with LRTI. The target audience for the guidelines is thus all those whose routine practice includes the management of adult LRTI.

This document begins with definitions and background sections on microbial cause, resistance and pharmacokinetics/pharmacodynamics, with conventional referencing. The guideline section captures management outside hospital, management inside hospital (including community-acquired pneumonia (CAP), acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and acute exacerbations of bronchiectasis) and prevention. The guidelines are about the management of infection. This means that for conditions such as AECOPD, aspects of management that are unreleated to infection (e.g. use of steroids or bronchodilators) are not included. It contains the graded recommendations but also the background information for each recommendation, with details about each new cited reference and the evidence grades. Because this is an update, original data and publications have usually not been repeated and the reader is referred to the original publication for this. As this is an update using the same methodologies, the layout of the document, including text, recommendations and evidence tables, is the same as in 2005.