Community Acquired Pneumonia Flashcards
CAP Definition
Pneumonia that develops in outpt setting or w/in 48 h of hospital admission
CAP Clinical Presentation
Cough, fever, chills, sputum, tachypnea, crackles, infiltrate/consolidation on imaging
CURB-65 Score
Confusion, Uremia ( BUN 20+ mg/dL), RR (30+), BP (less than 90/60), Age (65+)
CURB-65 Classification
0-1: outpatient
2-3: inpatient
3-5: inpatient (possibly ICU)
CAP Common Pathogens
S. pneumo, H. flu, Moraxella, atypicals
DRSP Risk Factors
Age 0-2 or 65+ yo, abx in prec 3 mos, multiple comorbidities, immunosuppressed, alcoholism, day care
CAP Outpatient No DRSP RFs
Macrolide or doxycycline
CAP Outpatient DRSP RFs
Levofloxacin OR (Beta-lactam (high dose amoxicillin or amoxillin/clavulanate) and macrolide (alt-doxycyline)
CAP Non-ICU
Beta-lactam (ceftriaxone, cefotaxime, ampicillin) plus macrolide (alt: doxycycline)
CAP Non-ICU PCN Allergic
Levofloxacin
CAP ICU
Beta-lactam (ceftriaxone, cefotaxime, ampiciilin/sulbactam) plus azithromycin or levofloxacin
CAP ICU PCN Allergic
Levofloxacin plus aztreonam
Pseudomonas Risk CAP
Culture w/ preliminary GNR, structural lung dz, bronchiectasis, COPD w. frequent steroid or abx use
MRSA Risk CAP
Necrotizing or cavitary pneumonia, post-flu, H/O MRSA
Pseudomonas CAP
Beta-lactam (Zosyn, cefpime, imipenem or meropenem) plas AG plus azithromycin or levofloxacin