Community Acquired Pneumonia In Adults.docx

Community Acquired Pneumonia in Adults Clinical Diagnosis Cough, fever, difficulty of breathing, and/or chills within the past 24 hours to less than 2 weeks [A-II]1, 5 associated with tachypnea (RR > 20 breaths/ min), tachycardia (CR > 100/min), and fever (T > 37.8’C) with at least one abnormal chest finding of diminished breath sounds, rhonchi, crackles or wheeze [Grade B]6 suggest community- acquired pneumonia.

Diagnostic Tests Chest x-ray is recommended for all

patients

clinically

diagnosed of

pneumonia

[A-II/Grade A ]3,6 Gram stain and culture of appropriate pulmonary secretions [Grade A]6 and pretreatment blood cultures [A-II]3 may be requested when drug resistance is suspected and for etiologic diagnosis.

Hospital Admission Classify patients by risk categories to help determine the need for hospitalization. Only moderate and high-risk CAP should be admitted. [GRADE A]6 (See Table 15)

Treatment Initial empiric therapy based on initial risk stratification is recommended. [Grade B]6 Among patients with identified etiologic agent, appropriate antimicrobials should be instituted.3 (See Table 16).

TABLE 15. CLINICAL FEATuRES of PATIENTS WITH CAP ACCoRDING To RISk (PSMID, 2004

Supportive Care Oxygen, hydration, and antipyretics may be given if needed.