Sputum examination - Gram stain and culture can provide clues to the causative organism. Invasive procedures - Transtracheal aspiration, transthoracic needle aspiration, bronchial brushings etc. Failure to improve as OPD patient. Anti tussives - only in exhaustive cough. The correct choice of antibiotic forms the main stay of treatment.
Further choice is guided by the investigations and specific organism responsible for pneumonia.
Way back in 1968, a high powered committee was set up by the Government of India headed by Dr. K.N. Rao, the then Director General of Health Services. Although, the committee was to investigate the problems of hospital acquired infections, the report submitted by the committee recognized the root cause of the problem as 'Hospital Waste'. India is also one of the first countries in the world to bring legislation in this direction. However, the irony is that even today, most of us, let alone the medical fraternity, are not aware of the problems of Bio - Medical Waste Management. The socalled 'pressure group' is also not very vocal in India.