Podcast 679: Antibiotics for CAP

Podcast 679: Antibiotics for CAP

Contributor: Peter Bakes, MD

Educational Pearls:

  • Community-acquired pneumonia (CAP) is normally stratified into outpatient-candidates vs. inpatient candidates for treatment
  • For outpatient treatment, antibiotic selection is driven by presence or absence comorbid health conditions (chronic lung/kidney/liver disease, DM, immunocompromised state, alcoholism, asplenia)
    • No comorbidities: High dose amoxicillin, doxycycline, azithromycin
    • Comorbidities: augmentin, cephalosporin, doxycycline, macrolide with fluoroquinolones as an alternatives
  • For inpatient treatment, standard treatment is a macrolide and 3rd-generation cephalosporin
    • Prior MRSA isolate or pseudomonas isolate as well as severe pneumonia are indications for adding MDR organism coverage with vancomycin and anti-pseudomonal coverage

References

Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581ST

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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Podcast 694: Complete Heart Block

Podcast 694: Complete Heart Block

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Podcast 693: Humerus Fractures

Podcast 693: Humerus Fractures

Contributor: Nick Tsipis, MD Educational Pearls: Humerus fractures can be characterized as proximal, midshaft, and distal fractures Proximal humerus fracture is the second-most common fracture in eld...

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Podcast 692: Pelvic Fractures

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Podcast 691: TXA in Head Bleeds

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Contributor: Ricky Dhaliwal, MD Educational Pearls: CRASH 3 Trial looked at over 12,000 patients with traumatic intracranial bleeds, randomizing patients to a therapy with TXA or standard of care wit...

12 Juli 20212min

Podcast 690: Rectal Oxygen. Nice,

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Contributor: Chris Holmes, MD Educational Pearls: In the 1700s, boxes lined the River Thames to pump smoke up the rectum to resuscitate people who had been found unconscious in the river Sea cucumber...

7 Juli 20213min

Podcast 689: Peri-Intubation Hypotension

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Contributor: Ricky Dhaliwal, MD Educational Pearls: Hypotension in patients requiring intubation should be resuscitated as much as possible While intubating, the negative inspiratory pressure goes aw...

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Podcast 688: tPA Before Thrombectomy

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Contributor: Aaron Lessen, MD Educational Pearls: DEVT Trial, a recent non-inferiority study, looked at giving tPA prior to endovascular thrombectomy and was stopped early because there was no benefi...

5 Juli 20212min

Podcast 687: STI Complications

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Contributor: Jared Scott, MD Educational Pearls: PID (pelvic inflammatory disease) occurs when the infection ascends into the uterus Tubo-ovarian abscess occurs when the infection ascends to the fall...

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