SHOULD BE IN CLINICAL- Hospital Acquired Pneumonia Flashcards
What flu vaccine do children receive?
Fluenz Tetra
*intranasal spray
*live attenuated virus
What vaccine do children receive for pneumonia?
Pneumococcal polysaccharide conjugate vaccine (PCV)
*get at 12 weeks and 1 yo
What vaccine do adults at high risk receive for pneumonia?
Pneumococcal polysaccharide vaccine (PPV)
*65+
*long term condition- either one off or every 5 years depending
What is HAP?
Pneumonia contracted by a patient 48-72 hours after hospital admission (mostly E. coli)
What are predisposing factors for HAP?
*stroke
*chronic lung disease
*mechanical ventilation
*previous antibiotics
Which patients are at higher risk?
*comorbidity- lung disease or immunosuppressed
*recent use of broad spectrum antibiotics
*colonisation of multi drug resistant bacteria
What is first line treatment of HAP if non severe ?
Co-amoxiclav 500/125mg orally three times daily x5 days
Alternative- doxycycline 200mg first day then 100mg daily for further 4 days
What is the first line treatment for HAP in severe cases?
Levofloxacin 500mg once daily (twice daily if more severe) IV
What antibiotics should be added to treatment if suspected MRSA?
Vancomycin- 15mg/ kg to 20mg/kg two or three times daily IV (adjust depending on serum vancomycin levels)
What is bronchitis?
Inflammation of bronchi
What are characteristics of acute bronchitis?
*last up to 3 weeks
*INFECTIVE
*complication of a viral URTI
*secondary bacterial infection- usually caused by already weakened respiratory system
What are characteristics of chronic bronchitis?
*daily predictive cough that lasts for 3 months of the year and for at least two years in a row
*long term inflammation of airways
*not primarily infective
*patients more susceptible to acute infections
What viruses can cause acute bronchitis?
Rhinovirus
Coronavirus
Influenza virus
What bacteria can cause acute bronchitis?
Streptococcus pneumoniae
Haemophilus influenzae
What are symptoms of bronchitis?
*productive cough- Green/yellow sputum (purulent)
*wheezing
*breathlessness
*rhonchi- loud abnormal sounds of chest
Are antibiotics prescribed in acute bronchitis?
No- self limiting illness. Unnecessary- increases chance of resistance
What is the potential antibiotic treatment for acute bronchitis?
First line adult- doxycycline 200mg stat then 100mg daily for 4 days
2nd line adult- amoxicillin capsules 500mg three times daily for 5 days
(Allergy- clarithromycin 500mg twice daily for 5 days
First line child- Amoxicillin oral suspension 125/250/500mg three times daily for 5 days
(Allergy- clarithromycin oral suspension based on weight for 5 days
What is bronchiolitis?
Inflammation and infection of bronchioles
(1 in 3 babies get during first year)
What are symptoms of bronchiolitis?
*wheeze
*cough
*rhinorrhoea-thin clear nasal discharge
