Pneumonia confirmed by
images
Suspect pneumonia dx by
Chest X-Ray
• Blood cultures
• Respiratory cultures
• Urinary antigens
What is CURB-65`
Confusion, (present =1point) Uremia, (BUN >19mg/dL=1point) Respiratory rate, (>30 =1point) Blood Pressure, (<90/60 =1point) =/> 65 (=1point)
CURB-65 score of 1
maybe outpatient
CURB-65 of 5
ICU care
Treatment of CAP outpatient
treat 5-7 days
Macrolide (azithromycin) or doxycycline
Treatment of CAP outpatient with comorbities
Respiratory fluoroquinolone
• Beta-lactam + macrolide
most common PNA pahtogens inpatient
staph aureus gram negative bacilli pseudomona kleb acinitibacter
Risk factors of MDR
hospital in last 2 day treat with broad specturm
Initial empiric therapy for HAP, VAP, HAP
cefepime
procalcitonin release for localized infection
wont changes
procalictonin above .5 and are symptomatics do you treat
yes
75% of respiratory infections are caused
virus
This shows multiple variables, stratifies patients into classes of mortality risk
pneumonia severity index
This facilitates dx of pneumonia in ventilated patients (VAP), by assessing clinical condition, infiltrates and cultures
clinical pulmonary infection score
What is the Pneumonia severity index
Looks at multiple comorbidity variables to separate patients into classes of mortality risk
What is the Clinical pneumonia infections score, what is measured (CLT T PC)
Facilitates Dx of pneumonia in VAP looks at condition,cultures, and infiltrate Chest xray Leukocyte temperature
Thoracic secreation
PaO2
Cultures
How many days would some one have to be out of a hospital or facility to have pneumonia classified as CAP
14 days
Treatment of community acquired pneumonia without comorbidities? With comorbidities
w/o:
5 to 7 day with azithromycin or doxycycline
with:
Respiratory fluoroquinolone
Carbapenum and azithromycin
inpatient treatment of community acquired pneumonia
fluoroquinolone
macrolide and carbapenem
how long should patient be afebrile before stopping antibiotic
48 to 72 hours
