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18 Cards in this Set

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Etiologies of CAP
-chlamydia (atypical)
-h. influenzae (-)
-legionella (atypical)
-moraxella (-)
-mycoplasma pneumoniae (atypcial)
-staph aureus (+)
-strep pneumoniae (+)
Upper lobe involvement indicates:
aspiration, TB
Lower lobe involvement indicates:
most bacterial pneumonias
Who should sputum staining and culture be performed for?
all patients admitted to the hospital
Empiric outpatient tx of CAP
-macrolide OR
-doxycycline OR
-FQ
Inpatient, general medical ward empiric treatment of CAP
-ES cephalosporin + macrolide
-BL/BLI + macrolide
-BL/BLI + FQ
Inpatient, ICU empiric treatment of CAP
-ES ceph +FQ
-ES ceph + macrolide
-BL/BLI + FQ
-BL/BLI + macrolide
Etiology of Nosocomial pneumonia
CAP +
-Gram - bacilli
-Anaerobes
-Stenotrophoomonas maltophilia
Empiric antibiotic therapy for HAP in patients with no known risk factors for MDR pathogens, early onset, and any disease severity
-ceftriaxone OR
-Levo, moxi, ciprofloxacin OR
-ampicillin/sulbactam OR
-ertapenam
Empiric antibiotic therapy for HAP in patients with late-onset disease or risk factors for MDR pathogens and all disease severity
Antipseudomonal ceph (cefepime, ceftazidime) OR
Antipseudomonal ceph (imipenam, meropenam) OR
BL/BLI (pipercillin/tazobactam)
**PLUS**
Antipseudomonal FQ (cipro, levo) OR
aminoglycoside (amikacin, gentamicin, tobramycin)
**PLUS**
Linezolid OR vancomycin
Duration of therapy for HAP
7-14 days; 14-21 days for severe infections caused by organisms such as pseduomonas
Non-pharmacological therapy
-O2, hydration, nutrition
-bronchodilators: albuterol-improve oxygenation in bronchospastic pts; ipratropium-dry excessive respiratory secretions)
-chest PT, smoking cessation
Treatment of drug-resistant S. pneumoniae therapy
-Telithromycin and newer generation FQs

-Vancomycin only for high-level drug-resistant S. pneumoniae infection
(>2mcg/ml)
Alcoholism
-strep pneumoniae
-anaerobes
Poor dental hygiene
anaerobes
Large-volume aspiration
anaerobes
Airway obstruction
-anaerobes
-s. pneumoniae
-h. influenzae
-s. aureus
Structural disease of lung (cystic fibrosis)
-pseudomonas
-s.aureus