1. Pneumonia goals of treatment
- Return to baseline respiratory status
- Fever resolves in 2 to 4 days
- Leukocytosis resolves by day 4 of
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- Chest x-ray may take 4 weeks or more to return
2. Common bacterial pathogens of Adult pneumonia
- S. pneumoniae
- Patients with underlying lung disease
- Nontypeable Haemophilus influenza and Moraxella catarrhalis
- Staph aureus: co-pathogen with influenza
- Mycoplasma pneumoniae
- Viral pneumonia
3. Common bacterial pathogens of Adult Community-Acquired Pneumonia
- Consult current treatment guidelines for the most recent treatment guidelines for community acquired pneumonia (CAP)
4. Common bacterial pathogens of CAP in pregnant women
- Main pathogens are S. pneumoniae
- H. influenzae, M. pneumoniae, and viruses
- Macrolides
- Pregnancy category B: erythromycin, azithromycin
- Pregnancy category category C: clarithromycin
- Comorbid conditions or recent antibiotics:
- Beta-lactam plus a macrolide
5. Common pediatric pneumonia pathogens
- S. pneumoniae is the most common cause of bacterial pneumonia in patients of all ages
- Increase in viral pneumonia with PCV7 vaccine
- Infants 4 to 16 weeks
- Consider chlamydia
- Over 5 years through adolescence
- Consider mycoplasma
- Community-acquired methicillin-resistant staphylococcus aureus
- Virus
6. Clinical practice guidelines for treatment of CAP
- Children under age 5 years
- Bacterial pneumonia (S. pneumoniae)
- Amoxicillin: 80 to 90 mg/kg/day
- Ceftriaxone: 50 mg/kg/day until able to take oral antibiotics
- Penicillin allergy: clindamycin or a macrolide
- Infant with suspected chlamydial pneumonia
- Azithromycin 20 mg/kg/day for 3 days OR erythromycin (EryPed) 50 mg/kg for 14 days
- Children 5 Years or Older
- Mycoplasma or other atypical most likely
- Azithromycin: 10 mg/kg on day 1 and 5 mg/kg on days 2 through 5
- Clarithromycin: 15 mg/kg per day in two divided doses (maximum 1 g/day)
- Erythromycin: 40 to 50 mg/kg/day
7. CAP treatment in pregnancy
- abx treatment:
- 1st choice: Erythromycin or azithromycin cat B. or Clarythromycin cat C.
8. Radiologic finding
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