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PHARM 559 Black 4.17 CAP
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What is "de-escalation"?
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If we convince ourselves that we know with reasonable certainty what the causative pathogen is, we can consider narrowing the antibiotic coverage.
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What is "de-escalation"?
If we convince ourselves that we know with reasonable certainty what the causative pathogen is, we can consider narrowing the antibiotic coverage.
What is the most common organism identified in a patient with CAP?
S. pneumoniae
If the CAP patient with COPD which two organisms might you be most concerned about?
S. pneumoniae
H. influenzae
If the CAP patient resides in a nursing home what other organisms besides the most common might you be concerned about?
Klebsiella
E. coli
What organism might you expect in a CAP patient who has just recovered from viral influenza or has been recently hospitalized?
S. aureus
What are the "atypical pathogens" suspected in CAP? What populations do they typically infect?
Mycoplasma pneumoniae - college age healthy persons
Chlamydia pneumoniae (Chlamydophila pneumophila) - healthy, older adults
Legionella - the immunocompromised (sometimes HCAP)
Why are the atypical pathogens called "atypical"?
They aren't detectable on Gram stain or won't grow on standard bacteriologic media.
They might also be associated with "atypical" signs and symptoms of disease.
What are the three big groups of antibiotics that cover the atypical pathogens?
Macrolides
Tetracyclines
FQs
What is "aspiration pneumonia"?
Pneumonia that has developed after the patient inhaled a very large amount of foreign material into the lower airways.
What coverage would need for "aspiration pneumonia"?
Oral anaerobic organisms
