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Pneumonia

Term 1Term 2
CAP CURB-65 Score of 0-1 CURB-65= Outpatient w/ PO ABX
CAP CURB-65 Score of 2 CURB-65= Outpatient/ inpatient PO or IV ABX
CAP CURB-65 Score of 3 CURB-65= Inpatient w/ IV ABX
CAP CURB-65 Score of 4-5 CURB-65= Inpatient ICU x/ IV ABX
TX for CAP CURB-65 score of 0-1 or PSI </=90 with NO comorbidities PO Amoxicillin, doxycycline, Azithromycin (if resistance <25%)
TX for CAP CURB-65 score of 0-1 or PSI </=90 WITH comorbidities PO: (Augmentin OR Cephalosporin) + (Azithromycin OR Doxycycline) -OR- Levofloxacin OR Moxifloxacin (Renal adjustment needed)
TX for CAP CURB-65 Score of 2+ or PSI >/=91 + NON Severe IV: Beta lactam + Azithromycin -OR- Levofloxacin or moxifloxacin -OR- beta lactam + doxycycline
TX for CAP CURB-65 Score of 2+ or PSI >/=91 + Severe + MRSA RISK IV: Beta lactam + Azithromycin -OR- Beta Lactam + Levofloxacin or moxifloxacin -AND- Vanco or linezolid
Criteria for a 5 day minimum tx for CAP Afebrile for >/= 48-72 hours meets 5-6 of the following: HR ≤100 beats/min RR ≤ 24 breaths/min SBP ≥ 90 mmHg O2 sat ≥ 90% on RA Tolerate PO intake Baseline mental status
Criteria for a 7 day max tx for CAP Initial ABX lacked coverage immunocompromised pt if pt has a current other infection or complication
CAP CURB-65 score of 0-1 or PSI </=90 with NO comorbidities MC pathogens Strep pneumoniae, atypical, viral
CAP CURB-65 score of 0-1 or PSI </=90 WITH comorbidities MC pathogens Strep pneumoniae, H. flu, M catarrhalis, Staph aureus, Pseudomonas
CAP CURB-65 Score of 2+ or PSI >/=91 + NON Severe MC pathogens Strep pneumoniae, atypical, viral
TX for CAP CURB-65 Score of 2+ or PSI >/=91 + Severe MC pathogens Strep pneumoniae, H. flu, M catarrhalis, Staph aureus, Pseudomonas, Legionella
HAP caused by a hospitalization < 5 days MC causes Strep pneumoniae, H. flu, Staph aureus, E coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas
HAP caused by a hospitalization >/= 5 days OR MDR risk MC causes Staph aureus and ESKAPE (E coli, Serratia marcescens, Klebsiella pneumoniae, Acinetobacter baumannii, pseudomonas, Enterobacter)
MRSA and other MDR Risk factor (pseudomonas) ABX within 90 days
Tx for HAP/ VAP Pip/ tazo, cefepime, levofloxacin, impipenem, or metropenem x 7days
TX for HAP/ VAP IF pseudomonas of Gram- MDR is suspected Pip/ tazo, cefepime, ceftazidime, aztreonam, impipenem, or meropenem -AND- cirpofloxacin, levofloxacon, or tobramycin x 7 days
TX for HAP/ VAP IF pseudomonas of Gram- MDR and MRSA MDR is suspected Pip/ tazo, cefepime, ceftazidime, aztreonam, impipenem, or meropenem -AND- cirpofloxacin, levofloxacon, or tobramycin -AND- vancomycin or linezolid x 7 days
TX for CAP CURB-65 Score of 2+ or PSI >/=91 + Severe IV: Beta lactam + Azithromycin -OR- Beta Lactam + Levofloxacin or moxifloxacin
Created by: rew12042000
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