The purpose of the updated guidelines is to provide specialists, primarily, anesthesiologists and intensive care physicians with modern evidence-based data on ethiology, epidemiology methods od diagnostic, treatment and prophylaxis of severe community-aquired pneumonia in adults. In the preparation of the current document, the high quality scientific studies, systematic reviews, meta-analyses, and the latest recommendations of Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS), and the European Respiratory Society/European Society of Intensive Care Medicine/European Society of Clinical Micribiology and Infectious Diseases/Asociacion Latinoamericana del Torax (ERS/ESICM/ESCMID/ALAT) as well as other leading professional communities have been analyzed, localized and implemented. Current guidelines provide up-to-date recommendations for the differential antibiotic treatment of severe CAP patients based on the existence of risk factors making them susceptible to the infection with certain microorganisms, and suggests etiotropic therapy regimens for cases where the causative agent has been identified. A substantial portion of the document focuses on the respiratory therapy for CAP, outlining a graded algorithm for the treatment of acute respiratory failure based on stage, and describing in detail the most effective and safe invasive and non-invasive respiratory support strategies. The proposed adjuvant therapies include glucocorticosteroids if it is impossible to stabilize hemodynamics by means of adequate hydration and vasopressor support, as well as parenteral anticoagulants to prevent thromboembolic complications. Pneumococcal and influenza vaccines are suggested as CAP prevention strategies for high-risk patients. The criteria on the quality of medical care are presented.