DOCs for Pneumonia Flashcards
Strep pneumoniae
non-resistant: Penicillin G, amoxicillin
resistant: cephalosporins, FQs, vancomycin, linezolid
Haemophilus influenzae
if not B lactamase producing: amoxicillin
if B lactamase producing: add B lactamase inhibitor
Mycoplasma pneumoniae
macrolide (azithromycin) OR tetracycline (doxycycline)
Chalmydophila pneumoniae
macrolide (azithromycin) OR tetracycline (doxycycline)
Chlamydophila psittaci
tetracycline (doxycycline)
Legionella spp
FQ, macrolide (azithromycin), tetracycline (doxycycline)
Enterobacteriaceae (Klebsiella, E coli, Enterobacter, Proteus)
3rd or 4th gen cephalosporin
**if produces B lactamase –> carbapenem (meropenem, ertapenem)
Pseudomonas aeruginosa
anti-pseudomonal B lactam (piperacillin)
PLUS
FQ (levofloxacin) or aminoglycoside (gentamicin)
Anaerobe (fusobacterium, bacteroides, peptostreptococcus)
Beta lactam + B lactamase inhibitor (amoxicillin + clavulanic acid), lincosamide (clindamycin)
Staph aureus
methicillin-sensitive: anti-staph penicillin (nafcillin, dicloxacillin, oxacillin)
methicillin-resistant (MRSA): vancomycin, linezolid
Pneumocystis jiroveci
trimethoprim/sulfamethoxazole
Bordetella pertussis
macrolide (azithromycin, clarithromycin)
Influenza virus
Oseltamivir
Coccidioides spp
no tx necessary if normal host
fluconazole or itraconazole if immunocompromised
Histoplasmosis
itraconazole
Blastomycosis
itraconazole
Empiric outpatient recommendations
previously healthy: marolide + doxycycline
at risk for DRSP: FQ or B lactam + macrolide
Empiric inpatient recommendations (non-ICU)
FQ or B lactam + macrolide
Empiric inpatient recommendations (ICU)
B lactam + macrolide or FQ
MRSA
add vancomycin or linezolid
