Pneumonia is one of the most serious infections in elderly persons. For example, individuals with nursing-home acquired pneumonia requiring hospitalization have a mortality rate of approximately 40%. In the frail, elderly patient, the clinical manifestations may be very nonspecific and consist only of confusion and falls; these individuals often may not present with either fever or cough. Sputum is frequently not available for culture in this population, and chest radiography for pneumonia may be confounded by underlying pulmonary or cardiac disease. Antibiotic therapy for pneumonia in older patients must often be empirical.