Community Acquired Pneumonia Flashcards
(20 cards)
CAP Definition
Pneumonia that develops in outpt setting or w/in 48 h of hospital admission
CAP Clinical Presentation
Cough, fever, chills, sputum, tachypnea, crackles, infiltrate/consolidation on imaging
CURB-65 Score
Confusion, Uremia ( BUN 20+ mg/dL), RR (30+), BP (less than 90/60), Age (65+)
CURB-65 Classification
0-1: outpatient
2-3: inpatient
3-5: inpatient (possibly ICU)
CAP Common Pathogens
S. pneumo, H. flu, Moraxella, atypicals
DRSP Risk Factors
Age 0-2 or 65+ yo, abx in prec 3 mos, multiple comorbidities, immunosuppressed, alcoholism, day care
CAP Outpatient No DRSP RFs
Macrolide or doxycycline
CAP Outpatient DRSP RFs
Levofloxacin OR (Beta-lactam (high dose amoxicillin or amoxillin/clavulanate) and macrolide (alt-doxycyline)
CAP Non-ICU
Beta-lactam (ceftriaxone, cefotaxime, ampicillin) plus macrolide (alt: doxycycline)
CAP Non-ICU PCN Allergic
Levofloxacin
CAP ICU
Beta-lactam (ceftriaxone, cefotaxime, ampiciilin/sulbactam) plus azithromycin or levofloxacin
CAP ICU PCN Allergic
Levofloxacin plus aztreonam
Pseudomonas Risk CAP
Culture w/ preliminary GNR, structural lung dz, bronchiectasis, COPD w. frequent steroid or abx use
MRSA Risk CAP
Necrotizing or cavitary pneumonia, post-flu, H/O MRSA
Pseudomonas CAP
Beta-lactam (Zosyn, cefpime, imipenem or meropenem) plas AG plus azithromycin or levofloxacin
Pseudomonas CAP PCN Allergic
Astreonam plus AG plus levofloxacin
MRSA CAP
ICU CAP plus vancomycin or linezolid
CAP IV to PO
Hemodynamically stable, improving clinically, able to take PO, functioning GI
CAP Duration of Tx
Minimum of 5 days, shoudl be afebrile for 48-72 h and have no more than 1 CAP-assoc sign of clinical instability
CAP-assoc. Clinical Stability Criteria
Temp: less than 37.8 (48-72 h), HR less than 100, SBP 90+, RR less than 24
