A study showed doxycycline to be comparable to levofloxacin (Levaquin) in effectiveness, length of hospital stay, and failure rate for empiric treatment of CAP doxycycline is also a less expensive option for hospitalized patients who are not admitted to the ICU.
:max_bytes(150000):strip_icc()/pneumonia-causes-5b0d70dea474be00375ae127.png "after effects of pneumonia in elderly")
For hospitalized patients not admitted to the ICU, an intravenous respiratory fluoroquinolone alone or an intravenous beta-lactam antibiotic combined with a macrolide or doxycycline should be given. If a patient has used an antibiotic in the previous three months, a drug from a different class should be prescribed to decrease the risk of pneumococcal resistance. A respiratory fluoroquinolone is another choice. pneumoniae is a concern in patients with comorbid illness or recent antibiotic therapy (within previous three months) and should be treated with an oral beta-lactam antibiotic (e.g., high-dose amoxicillin, amoxicillin/clavulanate, cefpodoxime) combined with a macrolide. Oseltamivir (Tamiflu) or zanamivir (Relenza)ĭrug-resistant S. Risk factors for methicillin-resistant Staphylococcus aureus
After effects of pneumonia in elderly plus#
The above beta-lactam antibiotic plus an aminoglycoside and an antipneumococcal respiratory fluoroquinolone The above beta-lactam antibiotic plus an aminoglycoside and azithromycin Outpatients with comorbidities * or antibiotic use in past three months †Ī respiratory fluoroquinolone (levofloxacin, gemifloxacin, or moxifloxacin ), or a beta-lactam antibiotic (high-dose amoxicillin, amoxicillin/clavulanate, or cefpodoxime) plus a macrolide ‡Ī respiratory fluoroquinolone, or a beta-lactam antibiotic plus a macrolideĪ beta-lactam antibiotic (ceftriaxone, cefotaxime, or ampicillin/sulbactam ), plus azithromycin (Zithromax) or a respiratory fluoroquinolone §Ī beta-lactam antibiotic (piperacillin/tazobactam, cefepime, imipenem/cilastatin, meropenem, or doripenem ), plus either ciprofloxacin (Cipro) or levofloxacin Previously healthy outpatients no antibiotic use in past three months Physicians should promote pneumococcal and influenza vaccination as a means to prevent community-acquired pneumonia and pneumococcal bacteremia. Adherence to the Infectious Diseases Society of America/American Thoracic Society guidelines for the management of community-acquired pneumonia has been shown to improve patient outcomes. Hospitalized patients may be switched from intravenous to oral antibiotics after they have clinical improvement and are able to tolerate oral medications, typically in the first three days. Those with risk factors for methicillin-resistant Staphylococcus aureus should be given vancomycin or linezolid. Those with risk factors for Pseudomonas should be treated with a beta-lactam antibiotic (piperacillin/tazobactam, imipenem/cilastatin, meropenem, doripenem, or cefepime), plus an aminoglycoside and azithromycin or an antipseudomonal fluoroquinolone (levofloxacin or ciprofloxacin). Patients with severe community-acquired pneumonia or who are admitted to the intensive care unit should be treated with a beta-lactam antibiotic, plus azithromycin or a respiratory fluoroquinolone. Inpatients not admitted to an intensive care unit should receive a respiratory fluoroquinolone, or a beta-lactam antibiotic plus a macrolide. For outpatients with comorbidities or who have used antibiotics within the previous three months, a respiratory fluoroquinolone (levofloxacin, gemifloxacin, or moxifloxacin), or an oral beta-lactam antibiotic plus a macrolide should be used. Initial outpatient therapy should include a macrolide or doxycycline. Selected diagnostic laboratory testing, such as sputum and blood cultures, is indicated for inpatients with severe illness but is rarely useful for outpatients.
Initial evaluation should determine the need for hospitalization versus outpatient management using validated mortality or severity prediction scores. Community-acquired pneumonia is diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging, usually an infiltrate seen on chest radiography.
0 kommentar(er)
