PNA Treatments

Question 1

What is the treatment for Outpatient CAP

Answer 1

No abx in last 3 mo and healthy: Macrolide or Doxycycline
Abx in last 3 mo/ RF for resistance: Respiratory fluoroquinolone or Beta-Lactam+Macrolide
If allergic to Penicillin, Ceftriaxone, Cefpodoxime, Cefuroxime

Question 2

What is the Beta lactam of choice for treating outpatient CAP if recently on Abx

Answer 2

High dose amoxicillin or Augmentin

Question 3

What are the respiratory fluoroquinolones

Answer 3

Levofloxacin
Gemifloxacin
Moxifloxacin

Question 4

How do you treat non ICU inpatient CPA

Answer 4

Respiratory Fluoroquinolone or Beta-Lactam+Macrolide

Same Tx as recently on abx outpatient CAP

Question 5

How do you treat ICU Inpatient CAP

Answer 5

(Anti-pneumo) Beta-Lactam + Azithromycin -or- Respiratory Fluoroquinolone
Penicillin allergy: Respiratory fluoroquinolone + Aztreonam

Question 6

How do you treat an ICU Inpatient CAP if there is a MRSA risk

Answer 6

Same drugs as Inpatient ICU, but add Vancomycin or Linezolid
Penicillin allergy: sub Aztreonam

Question 7

How do you treat ICU Inpatient CAP with Pneudomonas risk

Answer 7

(Anti-pneumo/anti-pseudo) Beta-Lactam + Ciprofloxacin or Levofloxacin -or-
(Anti-P&P) Beta-Lactam + Aminoglycoside + Azithromycin or Respiratory Fluoroquinolone
Penicillin Allergy: Sub Aztreonam

Question 8

How do you treat Pneumocystic Jirovecii PNA

Answer 8

Bactrim (21 days) +/- corticosteroids

Bactrim prophylaxis if CD4 <200, or pt with oral candidiasis

Question 9

How do you treat Aspiration Pneumonia

Answer 9

Clindamycin or Augmentin -or-

Penicillin+Metronidazole

Question 10

What are MRSA RF

Answer 10

ESRD
IVDU
Flu
Hx Abx

Question 11

What are Pseudomonas RF

Answer 11

Alcohol abuse
CF
Intubation
Cancer