CAP Flashcards
risk factors for CAP
asthma, bronchopulmonary dysplasia, CF, sickle cell disease, congenital heart disease
recent URTI, smoke exposure, crowded living environment
s/s of CAP
FEVER, COUGH, purulent expectorant, tachypnea (infants >70, children >50), resp. distress, crackles/rales, wheezing, ams, pulse ox <90%
gold standard diagnosis for CAP
chest x-ray
most common pathogens of CAP in birth to 20 day age group
Group B strep, gram neg enteric bacteria, listeria monocytogenes
most common CAP pathogens in 3 wk to 3 mo age group
S. pneumoniae, RSV
s. aurus, parainfluenza virus (PIV), m. tuberculosis
most common CAP pathogens in 3mo to 5yr age group
S. pneumoniae, RSV
H. influenzae, m. pneomoniae, m. tuberculosis
most common CAP pathogens in 5yr to 15yr age group
s. pneumoniae, m. pneumoniae, c. pneumoniae
h. influenzae, influenza a or b, adenovirus, m. tuberculosis
symptom resolution expectation after treatment in CAP
48-72 hours
CAP treatment for influenza pneumonia
oseltamivir
CAP treatment for atypical pneumonia
azithromycin
CAP treatment for bacterial pneumonia in the outpatient setting
amoxicillin or amoxicillin-clav (90 mg/kg/day in 2 doses)
CAP treatment for bacterial pneumonia in the inpatient setting
fully immunized patients
ampicillin or penicillin g
low MIC </ 2
CAP treatment for bacterial pneumonia in the inpatient setting
un-immunized patients
ceftriaxone or cefotaxime
high MIC >2
vaccine prevention of CAP
PCV-13 and Hib
Oseltamivir dosing
infants (<1yr) : 30 mg/kg/dose bid
</15 kg: 30 mg bid
15-23 kg: 45 mg bid
23-40 kg: 60 mg bid
>40 kg: 75 mg bid
oseltamivir duration
5 days
oseltamivir dosage forms
capsules and 6mg/mL suspension
CAP treatment duration
10 days (Azithro 5 days)
treatment of CAP if anaphylactic to penicillin
levofloxacin, linezolid, macrolide, clindamycin, bactrim
best predictor of pathogen in CAP
age
