COMMUNITY ACQUIRED PNEUMONIA

Question 1

CRB-65

Answer 1

Confusion
Raised respiratory rate (30 BPM+)
BP low (<90/60)
65+

Question 2

CRB-65 scores

Answer 2

3+ = hospital
1 or 2 = consider hospital assessment, esp. with 2
0 = treatment at home

Question 3

Low severity

Answer 3

CRB-65 = 0
Amoxicillin 500 mg TDS for 5 days
Alternatives:
- Clarithromycin 500 mg BD for 5 days
- Doxycycline 200 mg (day 1), then 100 mg for 4 days

Question 4

Moderate severity

Answer 4

CRB-65 = 1 or 2
1. Amoxicillin
1. if atypical pathogen suspected: Amoxicillin 500 mg TDS + Clarithromycin 500 mg BD for 5 days/ erythromycin (pregnancy)
2. OR (if penicillin allergy)
clari or Doxycycline 200 mg (day 1), then 100 mg for 4 days

Question 5

High severity

Answer 5

CRB-65 = 3+
Hospital admission
Co-amoxiclav + Clarithromycin/erythromycin (pregnancy)

2. levofloxacin

Question 6

add on

Answer 6

Add flucloxacillin if staphylococci suspected
Add vancomycin if MRSA suspected

Question 7

CAP in pregnancy

Answer 7

Erythromycin 500 mg QDS for 5 days