Respiratory Tract Infections: Bacterial Infections

Question 1

What is CAP?

Answer 1

Community Acquired Pneumonia

pneumonia contracted by a person with little contact with healthcare system

Question 2

When is CAP most common?

Answer 2

males
elderly
alcoholics
chronic diseases

Question 3

Causes of CAP

Answer 3

conventional bacteria majority eg. S. pneumoniae
then atypical bacteria
viruses

Question 4

Investigation of CAP

Answer 4

confirm diagnosis
assess severity of disease
define aetiological agent
identify complications

Question 5

Microbiological investigations

Answer 5

sputum analysis and culture
immunofluorescence on sputum samples
blood cultures
urinary pneumococcal and legionella antigen

Question 6

What is antimicrobial chemotherapt for CAP based on?

Answer 6

assessment of the likely pathogen
severity of the illness
liklihood of drug resistance

Question 7

How would you define severe CAP?

Answer 7

Confusion
Urea - >7 mmol/l
Respiratory rate >30/min
Blood pressure syst <90mmHg or dias <60mmHg
65 or older

Question 8

How to treat low-severity CAP

Answer 8

amoxicillin 500mgs qd for 5 days

if allergic: ciprofloxacin 400 mgs bd and vancomycin

Question 9

How to treat moderate severity CAP

Answer 9

same as low severity but for 7 days and clarithromycin 500mgs bd for 7 days
if allergic, same dose as low

Question 10

How to treat severe CAP

Answer 10

co-amoxiclav 1.2g tds and clarithromycin 500 mgs bd iv for 10 days