NICE summary of review conclusions Chest physiotherapy should not be recommended as a routine adjunctive treatment for pneumonia in adults as it is not supported by sufficient good quality evidence. Consideration could be given to using it only within the context of a research or audit project. The effect of reducing or stopping routine chest physiotherapy for pneumonia in adults is difficult to ascertain but is not likely to be detrimental to the quality of patient care. It is likely to result in productivity savings by allowing physiotherapists to focus on those patients more likely to benefit. The Implications for practice section of the Cochrane review stated: There is limited evidence indicating that osteopathic manipulative treatment and positive expiratory pressure may reduce the mean duration of hospital stay. Osteopathic manipulative treatment could also reduce the duration of antibiotic treatment, while positive expiratory pressure could reduce the duration of fever. However, based on current evidence, chest physiotherapy should not be recommended as a conventional adjunctive treatment for pneumonia in adults.