CAP

Question 1

CAP common bugs

Answer 1

S. pneumoniae (75%), also H flu, Legionella, Chlamydia, Mycoplasma

Question 2

CAP treatment - previously healthy (outpatient)

Answer 2

Macrolide or doxycycline

Question 3

CAP treatment - comorbid conditions or ABX treatment within 3 months (outpatient)

Answer 3

respiratory FQ, OR advanced macrolide + high dose amoxicillin (1 g PO TID), OR advanced macrolide + high dose amoxicillin/clavulanate (2g PO BID)

Question 4

CAP - Suspected aspiration (outpatient)

Answer 4

Amoxicillin/clavulanate OR clindamycin

Question 5

CAP - Influenza with bacterial superinfection

Answer 5

oral BL OR respiratory FQ

Question 6

CAP - (hospitalized)

Answer 6

REspiratory FQ OR Advanced ML + BL

Question 7

Risk factors for P. aeruginosa

Answer 7

severe functional lung disease (i.e. bronchiectasis, cystic fibrosis), chronic steroid administration, and frequent ABX therapy

Question 8

No P. aeruginosa + No beta lactam allergy

Answer 8

BL + azithromycin OR respiratory FQ

Question 9

No P. aeruginosa + Yes beta lactam allergy

Answer 9

Respiratory FQ +/- clindamycin

Question 10

Yes P. aeruginosa + No beta lactam allergy

Answer 10

Antipseudomonal BL + 1.Cipro OR 2.levo(750 mg QD) OR 3.aminoglycoside + azithromycin OR 4.aminoglycoside + antipseudomonal FQ

Question 11

Yes P. aeruginosa + Yes beta lactam allergy

Answer 11

same as yes pseudomonal + no beta lactam allergy except substitute aztreonam for antipseudomonal BL

Question 12

BL

Answer 12

cefotaxime, ceftriaxone, ampicillin, ertapenem

Question 13

aminoglycoside

Answer 13

tobramycin (for atypicals)

Question 14

Macrolide

Answer 14

azithromycin, clarithromycin, erythromycin

Question 15

Advanced ML

Answer 15

azithromycin, clarithromycin

Question 16

Respiratory FQ

Answer 16

levo, moxi, gemi

Question 17

Oral BL

Answer 17

high dose amoxicillin, high dose amox/clav, cefpodoxime, cefuroxime

Question 18

Antipseudomonal BL

Answer 18

Pip/Tazo, ceftazidime, cefepime, imipenem, meropenem, doripenem

Question 19

IV- PO conversion

Answer 19

1. Stable for 24 hours
   a. Temp < 37.8 (100)
   b. HR < 100 beats/min
   c. RR < 24 breaths/min
2. Able to take PO
3. adequate GI function

Question 20

Duration of CAP therapy

Answer 20

minimum 5 days, should be afibrile for 48-72 hours