Asthma

COPD
Acute Respiratory Failure
Pneumonia
ARDS
 CAP
<48hrs of admission and develop
respiratory symptoms.
Criteria Live in the community, does not
receive medical care
TYPICAL
HAP VAP
Occurs > 48hrs after admission
[not MV] Occurs 48-72hrs after
intubation
For at least 2 days in the last 90
days prior to infection.
 s. pneumonia Staph aureus
Pathogen H. influenzae Strep. Pneumoniae Pseudomonas
Moraxella Klebsiella
E.coli
ATYPICAL Acinetobacter
Mycobacterium RSV
Legionella Legionella
Mycoplasma PNA parainfluenza

Pseudomonas [healthcare]

Key indicators Dullness to percussion Look at the color of

Pleuritic chest pain the sputum
Crackles/rhonchi
CURB-65 [guide admission/clinical Initiate empiric therapy until
course organism is identified Antipseudomonal
Zosyn
< 60, -risk/comorbidity If not at  risk of MRSA Cefepime
Macrolides Zosyn Imipenem
azithromycin Cefepime Meropenem
erythromycin Levofloxacin Aztreonam
clarithromycin Imipenem
Doxy if allergic Meropenem
Management >60, +risk/comorbidity Empiric+ pseudomonas/MRSA
Fluroquinolones
Moxifloxacin A. Gram + with
Gemifloxacin antipseudomonal
Levofloxacin Vancomycin
Zyvox
Beta lactam/macrolide B. Gram – with
Amoxicillin antipseudomonal
Augementin Zosyn
Cefpodoxime Cefepime
Cefuroxime Ceftazidime
Ceftriaxone Meropenem
Aztreonam
ICU MNGT
If + pseudomonas: C. gram – antipseudomonal
Zosyn NON beta lactam
Cefepime Ciprofloxacin
Imipenem/meropenem Levofloxacin
PLUS, cipro/Levaquin Amikacin
Gentamycin
If + MRSA: Tobramycin
Vancomycin
Zyvox
Daptomycin

Doxy as alternative to macrolides.