CAP 2016

Question 1

Standard drug of choice for Low Risk CAP without comorbids illness

Answer 1

AMOXICILLIN

or may consider extended macrolides

Question 2

`LOW RISK CAP with stable comorbid

Answer 2

BLIC/2nd gen Cephalosporin with or without macroldies

Question 3

Moderate risk CAP

Answer 3

IV non antipseudomonal IV BLIC, cephalosporin with extended macrocodes or respiratory quinolone

Question 4

High risk without risk for pseudomonas

Answer 4

Combination of non antipseudomonal B lactic with IV extended macrolide or IV respiratory quinolone

Question 5

High risk with risk for pseudomonas

Answer 5

IV antipseudominal BLIC, antipneumococcal, and an IV ciprofloxacin or levofloxacin IV

Question 6

Moderate RISK CAP Vitals

Answer 6

RR>30
HR >125
BP = 90 =60
Temp = 36, >/= 40

Question 7

Moderate RISK CAP Other criteria

Answer 7

1. Altered Mental state acute onset
2. Suspected Aspiration
3. Uncontrolled diabetes
   4 Unstable comorbids
4. active malignancies
5. Neurologic disease in evolution
6. CHF Class II-IV
7. unstable CAD
8. Renal failure on dialysis
9. uncompensated COPD
10. Decompensated liver disease

Question 8

High risk CAP

Answer 8

Moderate cap features plue

severe sepsis or septic shock or need for MV

Question 9

Low Risk CAP Bacteria

Answer 9

Strep pneumo
Hinfluenzae
Chlamydia pneumonia 
Mycoplasma
Moraxella catarrhalis 
enteric gram neg bacili

Question 10

Moderate Risk CAP Bacteria

Answer 10

Strep pneumo
Hinfluenzae
Chlamydia pneumonia 
Mycoplasma
Moraxella catarrhalis 
enteric gram neg bacili 
Legionella pneumonia 
Anaerobes (Aspiration)

Question 11

His risk CAP Bacteria

Answer 11

Strep pneumo
Hinfluenzae
Chlamydia pneumonia 
Mycoplasma
Moraxella catarrhalis 
enteric gram neg bacili 
Legionella pneumonia 
Anaerobes (Aspiration)
Staph aurea
Pseudomonas aeruginosa

Question 12

Low Risk CAP Antibiotics Without comorbids illness

Answer 12

Amoxicillin 1g TID

Ex macrocodes:
Azithromycin 500mg OD
cLARITHROMYCIN 500MG bid

Question 13

Low Risk CAP Antibiotics Wit Stable comorbids illness

Answer 13

BLIC or 2nd gen cephalosporins +/- EX macro

Co amor 1 g BID 
Sultamicillin 750mg BID 
Cefuroxime 500MG BID 
\+/- 
Azithromycin 500mg OD 
Clarithromycin 500mg id

Question 14

Moderate Risk CAP antibiotics

Answer 14

IV non antipseudomonal IV BLIC or cephalosporin with extended macrocodes or respiratory quinolone

Ampi sul 1.5 q6
Cefuroxime 1.5q8
Ceftriaxone 2g OD 
\+ 
Azith/clartih
or Levofloxacin 500mg OD 
or Moxifloxacin 400mg OD PO

Question 15

Suspected Aspiration

Answer 15

Clindamycin 600mg Q8
Ampicillin Sulbactam 3g q6
Moxifloxacin 400mg OD PO

Question 16

High risk without risk for pseudomonas

Answer 16

Combination of IV non antipseudomonal B lactic with IV extended macrolide or IV respiratory quinolone

Ceftriaxone 2 gram OD 
Ertapenem 1g OD 
\+ 
Azith 500mg OD 
Levoflox 500mg OD 
Moxifloxacin 400mg OD

Question 17

High risk with risk for pseudomonas

Answer 17

IV antipseudominal BLIC (bloc, cephalosporin, carbapenem), antipneumococcal, + extended macrocodes + amino glycoside

Piptaz 4.5g q6 
Cefepime 2 g q8-12
Meropenem 1 g Q8 
\+ 
Azith 500mg iV 
\+ Gentamicin 3mg/kg OD 
Amikacin 15mg/kg OD 

OR

IV anti pneumococcal, antipseudominal Beta lactam (BLIC, cephalosporin, carbapenem), antipneumococcal
+ IV cipro/high dose levofloxacin

Piptaz 4.5g q6 
Cefepime 2 g q8-12
Meropenem 1 g Q8 
\+  Levofloxacin 750mg IV OD 
Ciprofloxacin 400mg q8-12 IV

Question 18

MRSA Pneumonia

Answer 18

Vancomycin 15mg/kg q8-12
Linezolid 600mg Q12
Clindamycin 600mg q8

Question 19

Length of Tx MSSA CAP

Answer 19

non bacteraemic 7-14

bacteraemic up to 21 days

Question 20

MRSA CAP

Answer 20

non bacteraemic 7-21 days

bacteraemic longer up to 28 days

Question 21

Pseudomonas aeruginosa

Answer 21

non bacteraemic 14-21 days

bacteremic longer up to 28 days

Question 22

Mycoplasma/Chlamydia

Answer 22

10-14 days

Question 23

Legionella

Answer 23

14-21 days, 10 days azalides