PC2 MOD 3.6

CAP

acquired outside of the hospital setting

HAP

acquired in hospital setting

greater than 48 hours after admission

VAP= greater than 48hrs after intubation

risk factors for CAP

immunosuppression

smoking & alcoholism

and the other obvious factors

typical bacteria seen in CAP

strep. pneumo

risk factors for drug resistant organisms strep pneumo

drug resistant strep pneumo

• age >65 yrs of age

• abxs w/in 3-6 months

• alcoholism

• immunosuppression

risk factors for drug resistant organisms MRSA

MRSA

• colonization

• hemoptysis

• empyema

risk factors for drug resistant organisms pseudo aeru

pseudo aeru

• recent hospitalization w/in 90 days

• recent abx use w/in 3 months

severity & site of care

CURB 65

clinical severity criteria adults

major

• respiratory failure requiring mechanical ventilation

• septicc shock with need for vasopressors

KEY POINT= pts who meet either of the major criteria OR at least 3 minor criteria have severe CAP & require ICU admission

CURB 65

confusion

uremia (BUN) (>20)

respiratory rate >30

BP (think hypotension <90/60)

AGE greater than or equal to 65

0-1= outpt

2= admit to hospital

3-5= admit to ward or ICU

anti pneumococcal beta lactams

ceftriaxone

ceftaroline

unasyn

anti-pseudomonal agents

cefepime

meropenem

zozyn

aztreonam