Inclusion Criteria:  Hospitalized adult ≥ 18 years old Moderate to severe CAP (CURB-65 score > 2 dan ATS/IDSA 2019)  Exclusion Criteria:  Have been taking antibiotic more than 24 hours before enrollment. Diagnose with non-infectious ARDS disease (such as aspiration pneumonia or cardiogenic pulmonary edema). Diagnose with tuberculosis based on clinical or radiological findings.