Adherence to such guidelines regarding use of antibiotics may positively influence prognosis [39] , but efforts to improve detection of pathogens should continue because enhanced specificity allows one to focus treatment on the responsible micro-organism and so limit the spectrum of coverage. The usual microbiologic techniques of detection may lack effectiveness. The use of urine antigens to Streptococcus pneumoniae and Legionella pneumophila type 1 can help in patients with pneumonia. Apart from their good sensitivity, the presence of these antigens can be detected long after an infection and, in the case of pneumoccocal related infection, may reflect carriage of the micro-organism in the upper respiratory tract [40] . Sensitive genomics tools are now available to detect both bacteria and viruses, and multiplex platforms allow screening of a wide range of micro-organisms [41] . The position of these techniques in the diagnostic armamentarium is yet to be defined, but efforts to improve antimicrobial therapy must continue so that our practices and therefore outcomes may be improved in the future.