Presentation?
- Dyspnoea
- Cough
- Productive yellow sputum
- chest pain: pleuritic
- fever
- reduced O2 ats
- reduced breath sounds/crackles
What are the investigations done in suspected pneumonia?
- Observations
- CXR
- bloods: FBC, U&Es, CRP
- Consider ABG if low O2 sats
What does CURB 65 stand for?
- C onfusion
- U rea > 7mmol/L
- R esp rate >30
- B P <90 systolic
- 65 aged or over
What does a CURB 65 score of 0 mean for management?
Patients with a CURB-65 score of 0 should be managed in the community.
What does a CURB 65 score of 1 mean for management?
Patients with a CURB-65 score of 1 should have their Sa02 assessed which should be >92% to be safely managed in the community and a CXR performed. If the CXR shows bilateral/multilobar shadowing hospital admission is advised.
What does a CURB 65 score of 2 mean for management?
*Patients with a CURB-65 score of 2 or more should be managed in hospital as this represents a severe community acquired pneumonia.
What does a CURB 65 score of 4 mean for management?
- Increase risk of mortality
* Critical care team involvement
What are the common causes of CAP?
1st: Strep pneumniae
2nd: Haem influenzae, Staph aureus
3rd: atypicals e.g. mycoplasma pneumoia
What antibiotic is used to treat low-severity CAP in the community?
- 1st line amoxicillin
* If penicillin allergic used macrolide or tetracycline
What antibiotic is used to treat moderate to high-severity CAP?
- dual antibiotic therapy is recommended with amoxicillin and a macrolide
- a 7-10 day course is recommended
- NICE recommend considering a beta-lactamase stable penicillin: co-amoxiclav, ceftriaxone or taz
What is defined as hospital acquired pneumonia?
Contracted by a patient in a hospital at least 48–72 hours after being admitted.
