CAP requiring ICU admission is a distinct clinical entity. The mortality rate of pneumonia in this subset of patients has been unchanged in the past several years. Aggressive diagnostic of strategies to establish the causative pathogens of pneumonia rapidly will enable clinicians to adjust antibiotic therapy appropriately. It is hoped that new adjunctive therapeutic options that positively influence host-related factors and bolster pulmonary antibacterial defense will result in reduced morbidity and mortality.