Community-Acquired Pneumonia

General
Facts and Figures
Classification

Presentation
History
Physical Exam
Labs
Radiology

Diagnosis
Criteria for diagnosis
Differential

Microbiology
General
Specific organisms

Pharmacology
Drug Classes
Mechanism of action
Resistance

Treatment
General
Site of care
Medication
Duration
Assessment of responce
Prevention

References
Literature cited
Complete bibliography

Links
More...






Treatment

Assessment of Response
  • parameters to monitor include respiratory symptoms, temperature, PO2, and WBC

  • resolution of symptoms may occur slowly, especially in patients with coexisting illness; fever should resolve within 2-4 days and leukocytosis within 4-5 days 26

  • repeat films are not indicated unless the clinical condition worsens or fails to improve

  • failure to improve can result from the presence of: a resistant organism, a nonbacterial pathogen, an unusual pathogen, a noninfectious cause, an infectious complication, or the presence of immunosuppression 27

  • if the patient fails to improve, reevaluate the case considering the above possibilities; repeat labs (blood cultures, urine cultures; check sputum for Legionella, TB, mycobacteria, or fungi), get an ECG to rule-out MI 28




Footnotes:

25) Campbell GD, Overview of community-acquired pneumonia: prognosis and clinical features, Medical Clinics of North America 1994, 78:1035-1048.

26) Bartlett JG, Mundy LM, Community-acquired pneumonia, NEJM 1995 Dec 14, 333(24):1618-24.

27) Campbell GD, Overview of community-acquired pneumonia: prognosis and clinical features, Medical Clinics of North America 1994, 78:1035-1048.

28) Campbell GD, Overview of community-acquired pneumonia: prognosis and clinical features, Medical Clinics of North America 1994, 78:1035-1048.

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