1. Treatment of Adult inpatient Non-ICU
1.1. Monotherapy
1.2. Combination
1.2.1. Cefotaxime,ceftriaxone,ampicillin-sulbactam, ertapenem
1.2.1.1. + azithromycin, clarithromycin, doxycycline
2. Treatment of Adult inpatient ICU (no pseudomons)
2.1. Combination
2.1.1. Cefotaxime or ceftriaxone
2.1.1.1. + Azithromycin, levofloxacin, moxifloxacin
3. Treatment of Adult inpatient ICU (Pseudomonas is a concern)
3.1. Combination
3.1.1. Cefepime, ceftazidim, piperacillin-tazobactam, imipenem, meropenem
3.1.1.1. + Ciprofloxacin, levofloxacin, aminoglycoside
4. Treatment of Adult inpatient ( MRSA is concern)
4.1. Combination
4.1.1. Any of the above regimens
4.1.1.1. + vancomycin, linezolid
5. Treatment of pediatric outpatient
5.1. Monotherapy
6. Amoxicillin, amoxicillin-clavulanate, IM ceftriaxone, azithromycin, clarithromycin
7. Treatment of pediatric inpatient Non-ICU
7.1. Monotherapy
7.1.1. Fully immunized
7.1.1.1. Ampicillin, penicillin G
7.1.2. Partially immunized
7.1.2.1. Ceftriaxone, cefotaxime
7.2. Combination
7.2.1. IV cefuroxime, cefotaime, ceftriaxone, ampicillin-sulbactam
7.2.1.1. + azithromycin, clarithromycin
8. Treatment of pediatric inpatient ICU
8.1. Combination
8.1.1. Cefotaxime, ceftriaxone
8.1.1.1. + Azithromycin, clarthromycin
9. Duration of treatment
9.1. Inpatients adult
9.1.1. Blood cultures +ve (sepsis)
9.1.1.1. 2 weeks from a day that the blood cultures turn -ve
9.1.1.1.1. Levofloxacin, moxifloxcin
9.1.2. Blood culture -ve
9.1.2.1. 5 days
9.2. Outpatients adult
9.2.1. 5 days
9.3. Pediatric
9.3.1. 10 days (exception azithromycin 5 days)
10. Outcome evaluation
10.1. Symptoms improvement in 24-72 hr
10.2. In NO improvement re-evaluate pt
11. Prevention (vaccination)
11.1. S.pneumoniae
11.2. Influenza virus
11.2.1. Trivalent - inj+ inactivation
11.2.1.1. 2 type A + 1 type B
11.2.2. Quadrivalent
11.2.2.1. 2 type A + 2 type B
12. Pathogens
12.1. S.pneumonia
12.1.1. Predominant 1st
12.2. H.influenzae
12.2.1. Inc. in COPD pt +cystic fibrosis
12.3. Mycoplasma pneumonia
12.3.1. 2nd most common (atypical)
12.4. C. pneumoniae, L. pneumophila
12.5. M. catarrhalis
12.5.1. Very young + very old
12.6. CA-MRSA
12.6.1. Necrotizing and sever pneumonia
12.7. Viruses (respiratory syncytial virus, influenza A, and parainfluenza)
12.7.1. Common cause in children
13. Pseudomonas aeruginosa
14. MDR
14.1. MRSA
14.2. Acinetobacter spp.
14.3. extended-spectrum β-lactamase-producing K. pneumoniae
15. Clinical presentation of CAP
15.1. S+S
15.1.1. Fever headache
15.1.2. Cough and SoB
15.2. Diagnostic
15.2.1. Chest x-ray, O2 saturation
16. Clinical presentation os sever CAP
16.1. Respiratory rate 30 breaths/min (Cyanosis)
16.2. Hypotension (90/60)
17. Treatment of Adult outpatient healty
17.1. Monotherapy
17.1.1. Amoxicillin, Azithromycin, clarithromycin, erythromycin, doxycycline
17.1.1.1. If Failure therapy
17.1.1.1.1. Non adherance
18. Treatment of Adult outpatient comorbidities
18.1. Monotherapy
18.1.1. Respiratory fluoroquinolone (Gemifloxacin, levofloxacin, moxifloxacin )
18.2. Combination
18.2.1. Amoxicillin/amoxicillin-clavulanate/cefpodoxime/cefuroxime/ceftriaxone
18.2.1.1. + azithromycin/clarithromycin/doxycyline