From the Education Institute (Dr Stoller) and Respiratory Institute (Drs Stoller, Banga, and Mehta), Cleveland Clinic.
CORRESPONDENCE TO: Atul C. Mehta, MD, FCCP, Respiratory Institute, Cleveland Clinic, 9500 Euclid Ave, A-90, Cleveland, OH 44195; e-mail: email@example.com
FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
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We appreciate the comments from Drs Sehgal and Agarwal affirming that American College of Chest Physicians (CHEST) guidelines are not global in coverage.1,2 Their arguments that the Infectious Diseases of America/American Thoracic Society guideline-based recommendation of quinolones for community-acquired pneumonia are ill advised in India because of the risk of incurring TB resistance and that use of urinary antigen diagnostics for Streptococcus and Legionella is unaffordable in resource-constrained settings affirm our arguments that North American-centric guidelines do not apply in the developing world.3-5 We agree with their proposed solution that CHEST guidelines must be revised by local chest societies to reflect the specific clinical and socioeconomic contexts in which the guidelines will be deployed.
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