Community Acquired Pneumonia (CAP)
Common pathogens
Streptococcus Pneumoniae (adults and children)
Mycoplasma Pneumoniae - Atypical bacteria
Viruses - RSV
H influenza (smokers/copd)
Staphylococcus aureus
Pseudomonas aeruginosa (cystic fibrosis)
Community Acquired Pneumonia (CAP)
First line treatment for previously healthy adults
Amoxicillin, doxycycline, macrolides are first line treatment for patients with noÂ
comorbidities/risk factors
Community Acquired Pneumonia (CAP)
What to give if first drug didn't work
Fluoroquinolones have been used; however, their use is discouraged unless the individual hasÂ
been treated with an antimicrobial agent within the last 90 days that could increase the risk of aÂ
drug-resistant microbe.
Treatment for M. Pneumoniae in pediatric patient (Specific/example antibiotic from drug classÂ
will be provided)
Macrolides/ erythromycin
Treatment of CAP in pregnancy
PCN and erythromycin
If someone has been treated with an antibiotic in the previous 90 days of contracting CAP, aÂ
_______________ would be a prudent choice to prescribe.
quinolone
Be familiar with drug examples within the Fluoroquinnolone classes.
ll END in "Floxacin"
Cirpofloxacin (Cipro)
Levofloxacin (Levaquin)
Moxifloxacin (Avelox)
Treatment of chlamydial pneumonia in infant
(options will include dose, but if you know the correct drug, the dose will come with it on theÂ
exam so no need to memorize dose)
erythromycin 50 mg/kg/day PO divided into four doses for 14 days for either conjunctivitis orÂ
pneumonia.
Azithromycin may also be used.
500mg orally on day 1 followed by 250 mg once daily for 2-5 days
when to use broad spectrum antibiotics
Targets a wider number of bacteria types, acts on both gram+/gram- organisms, commonly usedÂ
for empiric therapy when the pathogen is unknown or infection with multiple types of bacteria isÂ
suspected. Risks include dev. of abx. resistance.
Empiric antibiotics
What are they
Broad Spectrum
Empiric antibiotics
When to prescribe
Start treatment without cultures or prior to receiving the results of a culture. It is initiated whenÂ
the patient's history, typical pathogens, gram stain results, and local susceptibility reports onÂ
which antibiotics work best in certain geographic locations
Clostridium difficile associated diarrhea
How to Treat
First, STOP the antibiotics that could have caused it
Vancomycin or Metronidazole