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Respiratory Block: Microbiology > Community Acquired Pneumonia: Treatment Guidelines > Flashcards

Community Acquired Pneumonia: Treatment Guidelines Flashcards

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1
Q

What route of administration should be used for outpatient adults?

A

PO

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2
Q

What antibiotic should be given for outpatient adults, <65 years old, no antibiotics within 90 days and no comorbidities?

A

Amoxicillin

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3
Q

What antibiotic should be given for outpatient adults, >65 years old, antibiotics within 90 days or comorbidity?

A

Amoxicillin-clavulanate
OR
Cefuroxime

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4
Q

What alternative antibiotic can be used for outpatient adults?

A

Moxifloxacin
OR
Levofloxacin

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5
Q

What route of administration should be used for inpatient (non-severe) adults?

A

PO / IV

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6
Q

What antibiotic should be given for inpatient adults (non-severe), <65 years old, no antibiotics within 90 days and no comorbidities?

A

Ampicillin

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7
Q

What antibiotic should be given for inpatient adults (non-severe), >65 years old, antibiotics within 90 days or comorbidity?

A 
Amoxicillin-Clavulanate 
OR 
Cefuroxime 
OR 
Ceftriaxone
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8
Q

What alternative antibiotic can be used for inpatient (non-severe) adults?

A

Moxifloxacin
OR
Levofloxacin

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9
Q

What route of administration should be used for inpatient (severe) adults?

A

IV

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10
Q

What antibiotic should be given for inpatient adults (severe), <65 years old, no antibiotics within 90 days and no comorbidities?

A 
Amoxicillin-clavulanate 
OR
Cefuroxime 
OR 
Ceftriaxone 
PLUS 
Macrolide / Azalide
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11
Q

What antibiotic should be given for inpatient adults (severe), >65 years old, antibiotics within 90 days or comorbidity?

A 
Amoxicillin-clavulanate 
OR
Cefuroxime 
OR 
Ceftriaxone 
PLUS 
Macrolide / Azalide
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12
Q

What alternative antibiotic can be used for inpatient (severe) adults?

A

Moxifloxacin
OR
Levofloxacin

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13
Q

What antibiotic should be used for ambulant paeds 0-2 months old?

A

N/A

Recommend hospitalization for all children less than 2 months of age

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14
Q

What antibiotic should be used for hospitalized paeds 0-2 months old?

A
  1. Ampicillin / penicillin IV + Aminoglycoside
    OR
  2. Ceftriaxone / Cefotaxime IV
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15
Q

What antibiotic should be used for ambulant paeds 3 months - 5 years old?

A
  1. Amoxicillin PO
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16
Q

What antibiotic should be used for hospitalized paeds 3 months - 5 years old?

A 
1. Ampicillin IV / Amoxicillin PO 
OR 
2. Cefuroxime IV / Amoxicillin-clavulanate 
OR 
3. Cefotaxime / Ceftriaxone IV
17
Q

What antibiotic should be added for hospitalized paeds 3 months - 5 years old if S. Aureus is suspected?

A

Cloxacillin

18
Q

What antibiotic should be used for ambulant paeds 5 years and older?

A
  1. Amoxicillin PO

2. Macrolide PO if suspect Mycoplasma Pneumoniae or Chlamydophilia spp

19
Q

What antibiotic should be used for hospitalized paeds 5 years and older?

A 
1. Ampicillin IV / Amoxicillin PO 
OR 
2. Cefuroxime IV / Amoxicillin-clavulanate 
OR 
3. Cefotaxime / Ceftriaxone IV
20
Q

What antibiotic should be added for hospitalized paeds 5 years and older if S. Aureus is suspected?

A

Cloxacillin

21
Q

What antibiotic should be added for hospitalized paeds 5 years and older if M. Pneumoniae or Chlamydophilia spp is suspected?

A

Macrolide

22
Q

How is the diagnosis of CAP made?

A
  1. Fever AND/OR
  2. Breathlessness AND/OR
  3. Tachycardia AND/OR
  4. New focal chest signs
23
Q

The decision to hospitalize is based on any of the following:

A
  1. CRB-65 >1
  2. Elderly
  3. Comorbidity
  4. Cyanosis
  5. Complications e.g. pleural effusion
  6. Poor SES
24
Q

If patient is not hospitalized, what should be done?

A

TREATMENT!

  1. Young, no comorbid illness: High-dose amoxicillin
  2. Alternative in settings of low macrolide resistance for severe beta-lactam allergy: Macrolide / Azalide
  3. Elderly >65 years and / or comorbid illness: Amoxicillin-Clavulanate or 2nd generation cephalosporin
25
Q

If patient is hospitalized, what should be done?

A

Additional investigations as indicated:

  • sputum, gram stain & culture
  • blood culture
  • thoracentesis for pleural effusion
  • Xpert MTB / RIF
  • Haematology and biochemistry
26
Q

Severe CAP is determined based on what?

A
  1. Clinical assessment

2. CURB-65 >2

27
Q

If severe CAP is determined, what treatment should be given?

A

Amoxicillin/clavulanate OR 2nd or 3rd generation cephalosporin
AND
Macrolide/azalide

28
Q

If no severe CAP, what should be considered next?

A

Age >65 years?

Comorbidity?

29
Q

If patient is >65 years and / or has a comorbidity (no severe CAP) what treatment should be given?

A

Amoxicillin/clavulanate OR 2nd or 3rd generation cephalosporin
+/-
Macrolide/azalide

30
Q

If patient is <65 years and has no comorbidity (no severe CAP) what treatment should be given?

A

Amoxicillin / Ampicillin

Respiratory Block: Microbiology (7 decks)

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