PneumoniaSteven Podnos MD
Etiology• Aspiration primary cause for bacterial  pneumonia• Aerosol transmission important for  viral/atypical/TB• Abnorm...
Risk Factors• Community Acquired “Healthy”• Community Acquired “Sick”• Health Care Associated
Clinical Features• History• PE-  RR,Fever, Hypoxemia, Hypercapnia, Shock, Che  st Pain• Sputum• CXR• WBC, Na• ABG
Community Acquired Pneumonia• Etiology-Viral/Atypical/Bacteria-  Pneumococcus, H. Flu• Clinical Presentation guides both d...
Criteria for clinical stability.          Mandell L A et al. Clin Infect Dis. 2007;44:S27-S72© 2007 by the Infectious Dise...
Clinical indications for more extensive diagnostic testing.           Mandell L A et al. Clin Infect Dis. 2007;44:S27-S72©...
Therapy• Timing of first dose important• Length of Rx variable• Oral vs. IV considerations
Recommended empirical antibiotics for community-acquired pneumonia.                                                       ...
Health Care Associated Pneumonia•   Increased risk of aspiration if intubated•   Ventilator Care Bundles•   Other attempts...
Potential Pathogens                                        Combination Antibiotic Therapy*Pathogens listed in Table 3 and ...
Non Antibiotic Rx•   Oxygen•   ARDS net ventilation vs BiPAP•   IVF•   Resp RX
Non responders
Pneumonia
Upcoming SlideShare
Loading in...5
×

Pneumonia

556

Published on

Published in: Health & Medicine, Sports
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
556
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
32
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "Pneumonia"

  1. 1. PneumoniaSteven Podnos MD
  2. 2. Etiology• Aspiration primary cause for bacterial pneumonia• Aerosol transmission important for viral/atypical/TB• Abnormal host response may be important in immuncompromised patients- neutropenia, PCP• Important to know oral flora
  3. 3. Risk Factors• Community Acquired “Healthy”• Community Acquired “Sick”• Health Care Associated
  4. 4. Clinical Features• History• PE- RR,Fever, Hypoxemia, Hypercapnia, Shock, Che st Pain• Sputum• CXR• WBC, Na• ABG
  5. 5. Community Acquired Pneumonia• Etiology-Viral/Atypical/Bacteria- Pneumococcus, H. Flu• Clinical Presentation guides both decision to admit and initial Rx• Discuss Diagnostic Approach
  6. 6. Criteria for clinical stability. Mandell L A et al. Clin Infect Dis. 2007;44:S27-S72© 2007 by the Infectious Diseases Society of America
  7. 7. Clinical indications for more extensive diagnostic testing. Mandell L A et al. Clin Infect Dis. 2007;44:S27-S72© 2007 by the Infectious Diseases Society of America
  8. 8. Therapy• Timing of first dose important• Length of Rx variable• Oral vs. IV considerations
  9. 9. Recommended empirical antibiotics for community-acquired pneumonia. Mandell L A et al. Clin Infect Dis. 2007;44:S27-S72© 2007 by the Infectious Diseases Society of America
  10. 10. Health Care Associated Pneumonia• Increased risk of aspiration if intubated• Ventilator Care Bundles• Other attempts to prevent• Etiology, MDR, Gram neg, Staph and MRSA but can also have CAP type organisms
  11. 11. Potential Pathogens Combination Antibiotic Therapy*Pathogens listed in Table 3 and Antipseudomonal cephalosporin MDR pathogens (cefepime, ceftazidime) Pseudomonas aeruginosa or Klebsiella pneumoniae (ESBL+) Antipseudomonal carbepenem Acinetobacter species (imipenem or meropenem) or ß-Lactam/ß-lactamase inhibitor (piperacillin–tazobactam) plus Antipseudomonal fluoroquinolone (ciprofloxacin or levofloxacin) or Aminoglycoside (amikacin, gentamicin, or tobramycin) plus Methicillin-resistant Staphylococcus aureus (MRSA) Linezolid or vancomycinLegionella pneumophila
  12. 12. Non Antibiotic Rx• Oxygen• ARDS net ventilation vs BiPAP• IVF• Resp RX
  13. 13. Non responders
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×