Lung

Question 0

In relation to community aquired pneumonia: if a patient has a CURB65 score of 0-2 it is mild/moderate. What treatment should be given?

Answer 0

Amoxicillin (1g tds IV/PO.

If they are allergic to penicillin give doxycycline PO 200mg on day 1 then 100mg od (or IV clarithromycin)

Question 1

What do you think when a patient has a SEWS > 4 and infection?

Answer 1

SEPSIS

Question 2

In relation to community aquired pneumonia: if a patient has a CURB65 score of 3-5 it is classed as severe. What treatment should be given?

Answer 2

Co-amoxiclav IV + either clarithromycin IV or doxycycline PO 100mg bd.
If they are penicillin allergic give IV levofloxacin 500mg bd.

Step down to doxycycline 100mg bd for all patients with severe CAP

Question 3

In relation to hospital aquired pneumonia or aspiration pneumonia: if the patient is classed as severe, what would the treatment be?

Answer 3

IV amoxicillin + metronidazole + gentamicin, step down to PO co-trimoxazole + metronidazole (total IV/PO 7 days)
If penicillin allergic IV co-trimoxazole + metronidazole +- gentamicin, step down to PO co-trimoxazole + metronidazole

Question 4

In relation to hospital aquired pneumonia or aspiration pneumonia: if the patient is classed as non-severe what would the treatment be?

Answer 4

PO amoxicillin + metronidazole (5 days)

If penicillin allergic PO co-trimoxazole + metronidazole

Question 5

What antibiotic treatment is required in an acute exacerbation of COPD?

Answer 5

Give antibiotics if there is an increased sputum purulence. If no increasesd sputum purulence then no antibiotics unless consolidation on CXR or signs of pneumonia.

1st line - amoxicillin 500mg tds, 2nd line - doxycycline 200mg on day 1 then 100mg daily (5 days)