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The study was approved by the Lothian Research Ethics Committee. Studies from this dataset, not related to clinical stability criteria, have been previously published [16-18]. NHS Lothian serves a population of 826?231 in a geographical area of 1760 square kilometres in the east of Scotland. Patients were included in the study if they presented with a new infiltrate on a chest radiograph and had three or more of the following symptoms or signs: cough, sputum production, breathlessness, pleuritic chest pain, haemoptysis, fever, headache, and signs consistent with pneumonia on chest auscultation. Exclusion criteria included: hospital-acquired pneumonia (development of symptoms >48?h following admission or discharge from an acute care facility E-64 active thoracic malignancy, immunosuppression, pulmonary embolism on admission, and patients in whom active treatment was not considered JQ1 nmr appropriate (palliative care). All data reported in the study were collected by physicians or medical students trained in the study methodology. Local guidelines did not recommend any stability criteria for clinical use during the study period. Using the methodology originally described by Halm et?al. [7], we recorded daily laboratory and physiological variables, using the most abnormal result over each 24-h period. Halm's criteria measure clinical and physiological parameters and were derived and validated in CAP populations [7, 8]. We calculated Halm's criteria, which consist of seven clinical variables (temperature ��37.8��C, heart rate ��100 R428 cell line beats/min, respiratory rate ��24 breaths/min, systolic blood pressure ��90?mmHg, O2 saturation ��90% or arterial O2 tension��60?mmHg, normal mental status and normal oral intake). These were assessed on admission, and daily until all parameters were achieved, giving the time taken to clinical stability. Where abnormalities of these variables were usual for the patient (e.g. patients on long-term oxygen therapy or patients with cognitive impairment leading to chronic abnormal mental status), criteria were deemed to be met when the patient returned to their usual level of functioning. The ATS criteria [9] for advising intravenous to oral switch for antibiotics have been used to define clinical stability in a number of studies [13, 19]. They consist of four variables: improvement in cough and shortness of breath, afebrile status