Pneumonia

Question 1

Common Adult Pathogens

Answer 1

S. pneumoniae 
Patients with underlying lung disease
Nontypeable Haemophilus influenza and Moraxella catarrhalis
Staph aureus: co-pathogen with influenza
Mycoplasma pneumoniae
Viral pneumonia

Question 2

Healthy adults, no risk factors

Answer 2

Macrolide (level I evidence) (azithromycin or clarithromycin, erythromycin)
Doxycyline if allergic
Treat for a minimum of 5 days.

Question 3

Adults > 60 years old with comorbidities

Answer 3

Outpatient treatment option
Ceftriaxone (Rocephin) or levofloxacin
Switch to oral therapy once patient can tolerate oral medications.

Question 4

Pregnancy category B:

Answer 4

erythromycin, azithromycin

Question 5

Pregnancy category C:

Answer 5

clarithromycin

Question 6

Pregnancy

Answer 6

Main pathogens are S. pneumoniae, H. influenzae, M. pneumoniae, and viruses
Tx with macrolide

Question 7

Common Pediatric Pneumonia Pathogens

Answer 7

S. pneumoniae is the most common cause of bacterial pneumonia in patients of all ages. Increase in viral pneumonia with PCV7 vaccine.

Infants 4 to 16 weeks - Consider chlamydia.
Over 5 years through adolescence - Consider mycoplasma.
Community-acquired methicillin-resistant staphylococcus aureus
Virus

Question 8

Children < 5 years old

Answer 8

Bacterial pneumonia (S. pneumoniae)
Amoxicillin
Ceftriaxone

Question 9

Children 5 years or Older

Answer 9

Mycoplasma or other atypical most likely

Azithromycin
Clarithromycin
Erythromycin

Question 10

Patient Education

Answer 10

Patients should be told to expect clinical improvement in 48 to 72 hours.