Community-acquired pneumonia (CAP) is a common and serious illness. Analyses of administrative data show that large variations exist in admission rates, length of hospital stay, and use of institutional resources. OBJECTIVES: This study evaluated the medical management of patients hospitalized with Community Acquired Pneumonia (CAP) in an urban inner-city public hospital. The study was undertaken to identify areas for quality improvement. METHODS: A retrospective chart review was used to collect data on patients admitted to the hospital with a diagnosis of CAP during the period January 1, 2003 to April 30, 2004. Data were collected based on American Thoracic Society (ATS) criteria. RESULTS: Medical records of 155 patients were reviewed; overall mortality rate was 4%; 80% of patients received their first antibiotic dose in less than eight hours; 97% of patients had their oxygenation checked within 24 hours of admission. Only 45% of patients had at least one culture performed prior to initiation of antibiotics. The most commonly prescribed antibiotic was levofloxacin, representing 39% of all antibiotic orders. Using the ATS guidelines, 14 (9%) patients were considered to have received inappropriate antimicrobial treatment. Of these patients, 7 had severe cases of CAP requiring admission to an intensive care unit (ICU). The average length of stay for all patients was 7.64 days (SD + 0.327). Patients who received an antibiotic regimen that covered both typical and atypical organisms, as compared to those who did not, had a shorter length of therapy (7.33 days vs 9.79 days, p<0.05). CONCLUSION: Ongoing analysis of inpatients with CAP will provide information to evaluate improvement of clinical outcomes and to identify areas of focus for future performance improvement activities.