CAP Flashcards
CAP common bugs
S. pneumoniae (75%), also H flu, Legionella, Chlamydia, Mycoplasma
CAP treatment - previously healthy (outpatient)
Macrolide or doxycycline
CAP treatment - comorbid conditions or ABX treatment within 3 months (outpatient)
respiratory FQ, OR advanced macrolide + high dose amoxicillin (1 g PO TID), OR advanced macrolide + high dose amoxicillin/clavulanate (2g PO BID)
CAP - Suspected aspiration (outpatient)
Amoxicillin/clavulanate OR clindamycin
CAP - Influenza with bacterial superinfection
oral BL OR respiratory FQ
CAP - (hospitalized)
REspiratory FQ OR Advanced ML + BL
Risk factors for P. aeruginosa
severe functional lung disease (i.e. bronchiectasis, cystic fibrosis), chronic steroid administration, and frequent ABX therapy
No P. aeruginosa + No beta lactam allergy
BL + azithromycin OR respiratory FQ
No P. aeruginosa + Yes beta lactam allergy
Respiratory FQ +/- clindamycin
Yes P. aeruginosa + No beta lactam allergy
Antipseudomonal BL + 1.Cipro OR 2.levo(750 mg QD) OR 3.aminoglycoside + azithromycin OR 4.aminoglycoside + antipseudomonal FQ
Yes P. aeruginosa + Yes beta lactam allergy
same as yes pseudomonal + no beta lactam allergy except substitute aztreonam for antipseudomonal BL
BL
cefotaxime, ceftriaxone, ampicillin, ertapenem
aminoglycoside
tobramycin (for atypicals)
Macrolide
azithromycin, clarithromycin, erythromycin
Advanced ML
azithromycin, clarithromycin
Respiratory FQ
levo, moxi, gemi
Oral BL
high dose amoxicillin, high dose amox/clav, cefpodoxime, cefuroxime
Antipseudomonal BL
Pip/Tazo, ceftazidime, cefepime, imipenem, meropenem, doripenem
IV- PO conversion
- Stable for 24 hours
a. Temp < 37.8 (100)
b. HR < 100 beats/min
c. RR < 24 breaths/min - Able to take PO
- adequate GI function
Duration of CAP therapy
minimum 5 days, should be afibrile for 48-72 hours
