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Continuous variables were shown as an interquartile range (IQR) or mean?��?SD, two-sample t-test for a normal distribution and the Mann�CWhitney U-test for a non-normal distribution were used. Multiple logistic analysis was carried out to determine factors involved in doctors' decision to propose DNR. An �� error of less than 5% was considered significant. Out of 641 elderly CAP patients, 183 patients (28.5%) opted for DNR. The DNR group, containing more elderly patients with poorer performance status, showed higher rates of malnutrition, dementia, aspiration, very severe pneumonia, respiratory failure and mortality, as well as residence in healthcare facilities than the non-DNR group. The non-DNR http://www.selleckchem.com/products/BEZ235.html group showed a higher ratio of males, and more patients with gastrostoma than the DNR group (Table?1). Patients in the DNR group showed lower serum albumin levels, imaging of more extensive pneumonia and more severe pneumonia http://www.selleckchem.com/products/byl719.html determined by A-DROP than those in the non-DNR group. The concentration of CRP was not different between the two groups (Table?2). Although methicillin-sensitive Staphylococcus aureus (MSSA) and Esherichia coli were detected more in the DNR group than in the non-DNR group, S.?pneumoniae was detected more frequently in the non-DNR group. Drug-resistant bacteria were detected in both groups without significant difference (Table?3). Monotherapy accounted for the majority of antibiotic therapies in both groups. The rate of monotherapy was not significantly different. The frequency of combination therapy with ��-lactums and quinolones http://www.selleck.cn/products/gsk-j4-hcl.html was higher in the DNR group than in non-DNR group, whereas anti-pseudomonal agents were used in both groups without difference. The choice of antimicrobials was not affected by the presence of DNR orders (Table?4). The rate of improper treatment was not significantly different between both groups, with 28.2% (20 out of 71 cases) in the DNR group and 21.9% (42 out of 192 cases) in the non-DNR group. Positive efforts for detecting bacteria were made at a higher rate in the non-DNR group than in the DNR group (Table?4). The mortality rate within 30?days (33.9% vs 2.8%, P?