Pneumonia Tx - Community Acquired (CAP)

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Pneumonia Tx - Community Acquired (CAP) by Mind Map: Pneumonia Tx - Community Acquired (CAP)

1. Pseudomonas

1.1. Tx

1.1.1. Antipneumococcal Antipseudococcal beta-lactam

1.1.1.1. + either

1.1.1.1.1. Anti-Pseudomonal Fluoroquinolone

1.1.1.1.2. Aminoglycoside

1.1.2. Beta-Lactam Allergy

1.1.2.1. Aztreonam

1.1.2.1.1. +

1.2. Risk Factors

1.2.1. Bronchiectasis/COPD/Chronic Lung disease

1.2.1.1. Requiring frequent antibiotics

1.2.1.2. Requiring frequent steroids

2. CA-MRSA

2.1. Risk Factors

2.1.1. Prior Abx

2.1.2. Recent flu-like illness

2.1.3. IV Drug use

2.1.4. Contact sports

2.1.5. Men who have sex with men

2.1.6. Prisoners

2.2. Tx

2.2.1. Anti-Staph Antibiotic

3. Inpatient CAP

3.1. Anti-Pneumococcal beta-lactam

3.1.1. + either

3.1.1.1. Azithromycin

3.1.1.2. Respiratory fluoroquinolone

3.2. Beta-lactam allergy

3.2.1. Aztreonam

3.2.1.1. +

3.2.1.1.1. Respiratory fluoroquinolone

4. Outpatient

4.1. Tx

4.1.1. Previously Healthy

4.1.1.1. General Respiratory Antibiotic (macrolide/doxy)

4.1.2. Comorbidities or regional DRSP

4.1.2.1. either

4.1.2.1.1. Respiratory Fluoroquinolone

4.1.2.1.2. Beta-Lactam + Macrolide

5. Switching to Oral Therapy

5.1. factors to consider

5.1.1. fever

5.1.2. respiratory fxn (O2 sat>90, RR<24)

5.1.3. WBC count

5.1.4. GI (able to tolerate PO)

5.1.5. mental status at baseline

5.2. delay when

5.2.1. more than one factor

5.2.2. initial therapy failure/switched

5.2.3. other infxn (meningitis/endocarditis)

5.2.4. documented Pseudomonas/Stap/Other bug

5.3. No need to observe overnight in hospital when switching!

6. FU CXR

6.1. Not necessary, and NOT linked to clinical status!

6.2. In smoker age > 40, can help R/O malignancy after 7-12 wks

6.3. If pt improving, no routine CXR needed