Abx for non-severe bronchiectasis exacerbation - known to be colonised with pseudomonas.
Amoxicillin 1g Q8H
Doxycycline 100mg Q12H
Abx for severe bronchiectasis exacerbation - known pseudomonas colonisation
Ceftazidime 2g Q8H Piptaz 4.5 Q6H PLUS Gentamicin/Tobramycin OR Ciprofloxacin
What are other names for hypersensitivity pneumonitis?
Extrinsic allergic alveolitis
- caused by immunological reaction to an inhaled agent
- presents with fevers, chills, malaise, cough and SOB
- need to consider in context of occupational exposure
Farmer’s lung
Bird/fancier’s lung
Interstitial lung disease
- symptoms: progressive SOB, exercise tolerance and dry cough
sighs: fine creps, evidence of pulmonary hypertension and RHF - oxygen desaturation may occur with exertion
- IX: CXR, HRCT, connective tissue serology (ANA, ENA, RF, myositis Abx, ANCA)
Classification of ILD
ILD of known association: CT disease, drugs, occupational
Granulomatous ILD: sarcoidosis, hypersensitive pneumonitis
Idiopathic (IIP): IPF, non specific IPF, crytogenic organising pneumonia (BOOP), acute interstitial pneumonia
Miscellaneous ILD: LAM and histocytosis X
Idiopathic pulmonary fibrosis`
- often seen > 60, male and assoc with smoking
- may seen finger clubbing
- poor prognosis with 2-3 median survival from diagnosis
Cryptogenic organising pneumonia
- may present similarly to CAP
- associated with malaise, fevers and cough
- good prognosis with rx of corticosteroids
Management of interstitial lung disease
- smoking cessations
- antifibrotic agents: nintedanid and pirfenidone
- lung transplant
Empirical therapy for CAP
Mild - amoxicillin 1g Q8H, doxy 100mg BD if suspect atypical
Mod - benzypenicillin 1.2g Q6H + doxycycline 100mg BD
Severe - ceftriaxone 2g and azithromycin 500mg
Pertussis Abx
Azithromycin 500mg on the first day followed by 250mg for a further four days
