Shared Flashcard Set

Details

Chapter108 - CAP
Community Acquired Pneumonia
19
Medical
Professional
09/07/2011

Additional Medical Flashcards

 


 

Cards

Term
What is the single most sensitive & specific sign of severe pneumonia in adults?
Definition
A respiratory rate > 30
Term
What PSI (pneumonia severity of illness score) requires hospital admission? does not require hospital admission?
Definition
PSI > 90 requires hospital admission.
Term
How long should Abx treatment last outpatient?

Inpatient?

Severe legionnaires?

Bacteremic aerobic gram(-) pneumonia ?

Pseudomonas aeruginosa ?
Definition
How long should Abx treatment last outpatient - 5 days

Inpatient - if respond within 48 hours, 10 days

Severe legionnaires - 21 days

Bacteremic aerobic gram(-) pneumonia - 14 days

Pseudomonas aeruginosa - 21 days
Term
Aspiration pneumositis - when does it require Abx therapy? DOC for when indicated?
Definition
Not necessary unless: Poor dental hygiene, putrid sputum, alcoholics Treat with DOC: metronidazole Others: clindamycin, beta lactams, carbapenems, fluoroquinolones
Term
Initial treatment:
PSI < 90 and NOT hypoxemic, and previously healthy ?
Definition
Initial treatment:
PSI < 90 and NOT hypoxemic, and previously healthy:

po macrolide or doxycycline po
Term
Initial treatment:
PSI < 90 and NOT hypoxemic, and co-morbidities such as diabetes, alcoholism, immunosuppressive conditions, use of Abx in last 3 months, CKD, lung or cardiac disease ?
Definition
PSI < 90 and NOT hypoxemic, and co-morbidities such as diabetes, alcoholism, immunosuppressive conditions, use of Abx in last 3 months, CKD, lung or cardiac disease ?

Respiratory fluoroquinolone (levo/moxi) po, or macrolide + either amoxicillin or amoxicillin/clav.

Do not use erythromycin monotherapy.
Term
Initial therapy for: PSI > 91, Ward
Definition
Initial therapy for: PSI > 91, Ward

Respiratory fluoroquinolone (levo/moxi)

or

Macrolide + B-lactam (penicillins, cephalosporins, monobactams, carbapenem)
Term
Initial therapy for: PSI > 91, ICU
Definition
Initial therapy for: PSI > 91, ICU

Beta lactams ((penicillins, cephalosporins, monobactams, carbapenem)

AND

Either respiratory fluoroquinolone, OR Macrolide
Term
Initial treatment for ICU pseudomonas aeruginosa suspected?
Definition
Initial treatment for ICU pseudomonas aeruginosa suspected?

Antipseudomonal B-lactam (cefepime, imipenem, meropenam, pip/tazo)

PLUS:

cipro

OR

Aminoglycoside + macrolide

OR

Aminoglycoside + cipro
Term
Abx therapy for CAP, pathogen: Strep Pneumoniae non-resistant resistant Alternatives for penicillin allergy?
Definition

Abx therapy for CAP, pathogen: Strep Pneumoniae

 

Penicillin non-resistant: Penicillin G, amoxicillin

 

 

Alternative for penicillin non-resistant: macrolide or respiratory fluoroquinolone or doxycycline, or clindamycin, cephalosporins

 

Penicillin Resistant: cefotaxime, ceftriaxone, or respiratory fluoroquinolone

 

 

Alternative for penicillin resistant: Vanco or linezolid or HD amoxicillin

Term
Abx therapy for CAP, pathogen: H. influenzae

if non beta-lactamase ?
Definition
Abx therapy for CAP, pathogen: H. influenzae

2nd OR 3rd gen cephalosporin OR Amoxicillin/clav, fluoroquinolones, doxycycline, azithro, clarithro,

Non-beta lactamase - amoxicillin monotherapy
Term
Abx therapy for CAP, pathogen: Staph. Aureus

Resistant

Non-resistant
Definition
Abx therapy for CAP, pathogen: Staph. Aureus.

non-resistant - cloxacillin, cefazolin, clindamycin

resistant - vancomycin, linezolid, tigecycline
Term
Abx therapy for CAP, pathogen: Legionella
Definition
Abx therapy for CAP, pathogen: Legionella
Fluoroquinolones or Azithromycin
Term
Abx therapy for CAP, pathogen: Mycoplasma pneumoniae or Chlamydophylia pneuomoniae
Definition
Abx therapy for CAP, pathogen: Mycoplasma pneumoniae or Chlamydophylia pneuomoniae:
Macrolides, tetracyclines
Term
Abx therapy for CAP, pathogen: Coxiella burnetii
Definition
Abx therapy for CAP, pathogen: Coxiella burnetii:

Doxycycline, FQs, Macrolides
Term
Abx therapy for CAP, pathogen: aerobic gram(-) bacilli:
Definition
Abx therapy for CAP, pathogen: aerobic gram(-) bacilli:

3rd gen cephalosporin, carbapenem
Term
Abx therapy for CAP, pathogen: Pseudomonas Aeruginosa
Definition
Abx therapy for CAP, pathogen: Pseudomonas Aeruginosa

Beta-lactam +

Cipro OR aminoglycoside Or BOTH!
Term
When should a PSV booster be used? How should re-immunization be carried out (specific to ages)
Definition
PSV - use in high risk patients such as CKD or immunosuppressed.

reimmunize after 5 years in those >10 when taken first shot, and after 3 years in those <10 when taken first shot.
Term
Healthy pregnant woman with CAP, what Abx?

Severe CAP?

High macrolide or Beta-lactam resistant settings?

Pseudomonas Aerginosa ?
Definition
Abx of choice - macrolides

Severe CAP - Beta-lactam & macrolide

resistant settings - FQs

P. Aeruginosa - antipseudomonal Beta-lactam (imipenem, meropenem, Pip/tazo, cefepime) + azithro + aminoglycoside
Supporting users have an ad free experience!