Community Acquired Pneumonia (CAP)
CAP Inpatient Treatment

CAP Inpatient Treatment

Clinical Considerations

  • Prior respiratory isolation of MRSA (within 1 year)
  • Recent hospitalization and parenteral antibiotics (within 90 days)
  • Post viral infection (ex: Influenza)
  • Cavitary lesion
  • Severe Disease: Empirically add MRSA coverage
  • Non-Severe Disease: Withhold MRSA coverage unless cultures & MRSA nasal PCR result positive
  • Prior respiratory isolation of P. aeruginosa (within 1 year)
  • Recent hospitalization and parenteral antibiotics (within 90 days)

Preferred Empiric Therapy

PLUS

OR

Lacks Legionella & B. pertussis coverage

Severe Beta-Lactam Allergy

If MRSA Suspected, ADD

Obtain MRSA nasal PCR to guide de-escalation

If Pseudomonas Suspected, Replace Ceftriaxone with

OR

See antibiogram for decision to use Cefepime empirically

Duration of Therapy

5 days with clinical improvement (afebrile x48h, vital signs stable), resolution of hypoxia, and absence of complicating factors

Decreasing PCT can guide discontinuation

Confirmed MRSA or Pseudomonas PNA may require longer treatment if extensive disease