Week 8 matt

When patients require mechanical ventilation, whether invasive or non-invasive.

5-7 days, with outpatients benefiting from shorter courses, typically ≤5 days.

Respiratory fluoroquinolones (e.g., Levofloxacin, Moxifloxacin).

Amoxicillin-clavulanate (500 mg/125 mg PO TID or 875 mg/125 mg PO BID).

More severe symptoms with persistent or worsening fever (≥102°F) for 3-4 days.

When clinical and radiological evidence of pneumonia is present.

Methicillin-resistant Staphylococcus aureus.

Rapid onset of otalgia (ear pain).

Tugging, rubbing, or holding the ear.

Symptoms persist for more than 12 weeks.

Four or more episodes per year, each separated by at least 10 symptom-free days.

Mild to moderate symptoms including purulent nasal discharge, nasal obstruction, facial pain, headache, ear pain, cough, and fatigue.

Chronic obstructive pulmonary disease (COPD), heart disease, or structural lung diseases.

Streptococcus pneumoniae.

Cloudy and bulging tympanic membrane, impaired mobility, and hemorrhagic or moderate/severe erythema of the tympanic membrane.

Haemophilus influenzae.

Doxycycline 100mg BID or Macrolides (Azithromycin or Clarithromycin) in regions with pneumococcal resistance <25%.

Amoxicillin: 80-90 mg/kg/day PO, divided every 12 hours.

A Beta-lactam combined with a Macrolide or Respiratory Fluoroquinolones as monotherapy.

Acetaminophen: 10-15 mg/kg/dose PO every 4-6 hours.

MRSA and Pseudomonas aeruginosa.

Supportive care including analgesics, saline irrigation, and intranasal glucocorticoids.

They reduce airway inflammation, improve oxygenation, and shorten recovery time.

It resolves between 4 and 12 weeks.

Over-prescription, with 81% of diagnosed adults receiving antibiotics despite most cases being viral.

Day care attendance, presence of siblings, cigarette smoke exposure, lack of breastfeeding, younger age, anatomic malformations, seasonal allergies, and winter months.

Antibiotics are indicated when patients exhibit at least two of the following: increased dyspnea, increased sputum volume, or increased sputum purulence.

Human rhinovirus.

To shorten recovery time, reduce the risk of early relapse, and decrease hospital stays.

Oral decongestants, antihistamines, and mucolytics.

5 - 7 days.

Sinusitis occurs due to obstruction of the sinuses, often caused by local edema from an upper respiratory infection or allergies, leading to viscous secretions and decreased mucociliary clearance.

Prior antibiotic use within 90 days.

Respiratory Syncytial Virus (RSV).

Pseudomonas aeruginosa.

Amoxicillin 1g TID.

Amoxicillin/clavulanate or a Cephalosporin combined with a macrolide or Doxycycline.

Amoxicillin-Clavulanate: 80-90 mg/kg/day amoxicillin with 6.4 mg/kg/day clavulanate.

Cefdinir, Cefuroxime, Cefpodoxime, Ceftriaxone, Clindamycin.

Vancomycin for MRSA or Piperacillin-Tazobactam for Pseudomonas.

Pneumococcal vaccine (PCV 15, PCV 20).

Prednisone 40 mg daily for 5 days.

Vancomycin or Linezolid.

Haemophilus influenzae type b (Hib) vaccine.

The patient’s condition.

5-7 days, with extended durations for MRSA or Pseudomonas infections.

Short-acting beta-agonists (SABA) and short-acting muscarinic antagonists (SAMA).

Annual Influenza vaccine.

Presence of at least two major symptoms or one major and two minor symptoms.

By stimulating beta-2 adrenergic receptors, causing bronchodilation.

Rhinosinusitis occurs when sinus openings become blocked, leading to inflammation of the mucosal lining of the nasal passage and paranasal sinuses due to mucus buildup.

Allergens, environmental irritants, and infections (viral, bacterial, or fungal).

It resolves in less than 4 weeks.

Aminopenicillins with clavulanic acid (e.g., Amoxicillin/clavulanate) and macrolides (e.g., Azithromycin).

It has anti-inflammatory properties and helps reduce airway inflammation and mucus production.

Higher dose amoxicillin-clavulanate, doxycycline, levofloxacin, or clindamycin + cefixime/cefpodoxime in children.

Being under 2 or over 65, recently hospitalized, or immunocompromised.

The patient can typically be treated as an outpatient.

It helps with bronchodilation and has anti-inflammatory properties.

Oxygen therapy, non-invasive ventilation (NIV), and invasive mechanical ventilation.

Fever typically resolves within 48 hours.

It often results in ICU admission.

Prior antibiotic use, mechanical ventilation, and prolonged hospitalization.

Penicillin-binding protein mutations.

Symptoms last more than 10 days or worsen starting around days 5-6.

Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Legionella species, Staphylococcus aureus, Chlamydia pneumoniae.

They increase the risk for resistant infections, especially in the ICU.

Pseudomonas aeruginosa, MRSA, and Gram-negative bacteria.

VAP occurs more than 48 hours after endotracheal intubation and mechanical ventilation, increasing the risk of infection by drug-resistant bacteria.

They are clinical prediction tools that guide treatment decisions based on patient risk factors and pneumonia severity.

They prevent infections that could lead to COPD exacerbations.

It focuses on Confusion, Urea levels, Respiratory rate, Blood pressure, and Age (≥65).

Less than 10 days with improvement.

Hospitalization.

Similar to HAP, but with a higher risk of resistant organisms like Acinetobacter and Pseudomonas aeruginosa.

Age, comorbidities, respiratory rate, blood pressure, and level of consciousness.

Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA), Acinetobacter baumannii, Gram-negative bacilli (e.g., Klebsiella, Escherichia coli).

Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae.

HAP occurs 48 hours or more after hospital admission and is not present at the time of admission, often involving multi-drug resistant pathogens.

Patients are classified into five risk classes, with Class I being the lowest risk (typically treated as outpatient) and Class IV or V being the highest risk (often requiring ICU care).

CAP is pneumonia that occurs in an outpatient setting or within the first 48 hours of hospital admission, primarily caused by pathogens encountered outside healthcare facilities.

Chronic diseases (e.g., heart, lung disease), smoking, and immunosuppression.