Lecture 21

Question 1

HAP

Answer 1

developing pneumonia greater than 48 days after admission

Question 2

early admisison HAP

Answer 2

within 96 hours (5 days)

Question 3

late admission

Answer 3

HAP after 5 days

Question 4

what causes hap

Answer 4

colonization of oropharyngeal tract, microaspiration of oropharyngeal content

Question 5

Diagnostic criteria for HAP

Answer 5

abnormal findings on chest radiograph PLUS

at least 2 of
- fever, leukocytosis, purulent tracheal secretions

Question 6

what do polymorphs indicate

Answer 6

inflammation

Question 7

Hap treatment early onset, mild/mod, no risk factors for resistance

Answer 7

Ceftraixone 1-2g IV q24h x 7 days

OR

moxifloxavin 400mg PO/IV daily x 7 days

Question 8

HAP treatment late onset severe or risk factors for resistance, isolation of resistant organisms

Answer 8

if no MRSA suspected:
1. piptazo 3.375 g IV q6hours x 7 days
2. miropenem 500mg IV q6hours x 7 days

Question 9

HAP treatment Late onset same as above MRSA suspected

Answer 9

add vanco, 25mg/kg IV load, then 15mg/kg q6-12h x 7 days minimum

Question 10

VAP MOA

Answer 10

leakage of endotracheal secretions around endotracheal cuff, aspiration of endotracheal secretions

Question 11

treatment for VAP

Answer 11

SAME AS HAP

Question 12

ASPIRATION PNEUMONIA

Answer 12

Inhaltion of oropharyngeal or gastric contents in the larynx and lower resp tract

Question 13

asp pneumonia treatment mild-mod

Answer 13

amoxi-clav 875mg/125 mg PO q12 h
OR
ceftriaxone 1-2g IV q24h +/- metronidazole 500mg PO/IV BID

Question 14

asp pneumonia treatment severe illness

Answer 14

Piptazo 3.375 g IV q6h or meropenem 500mg IV q6h