With regard to patients presenting at the ED because of community-acquired pneumonia (CAP), a recent report from Dremsizov and coworkers [7] illustrated the limited value of the well established criteria for 'systemic inflammatory response syndrome' (SIRS) in predicting outcome. That work emphasizes the inability of the SIRS designation to identify which infected patients were at risk for developing severe sepsis or shock. These findings prompted experts to propose new scoring systems aimed at identifying patients who are at [9] outcomes in patients presenting at an ED with infection, and calculation of this score requires data that are immediately available in the ED. Despite its ability to predict all-cause death in the study population, the accuracy of the MEDS score has not been tested at the individual patient level; its use at the bedside has not been evaluated, and therefore this tool should not be used in decisions regarding triage and ICU referral [10] . Most of the other newly developed scoring systems appear to have only marginal utility in daily routine practice because they require microbiologic identification and 24-hour clinical evaluation; hence, they lack the immediacy that is required for decision making in emergency medicine [6] . To date, the Pneumonia Severity Index is the only scoring system that is considered to help physicians to assess severity of illness in the ED [11] . Using this score at the bedside allows better triage of lowrisk patients [12] [13] [14] , but it does not alter outcomes in more severe pneumonia [15] , in which it is only slightly more effective than the inadequate SIRS classification [7] .