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PNEUMONIA (COMMUNITY ACQUIRED PNEUMONIA (SYMPTOMS (Tachypnoea (Abnormal…

- - - - Confusion
      - Respiratory Rate
      - Blood pressure
      - 65 years old
    - - Consider
        
        Patient's social circumstances
        
        Stability of co-morbid illness
  - - - Abnormal rapid breathing
  - - - Hospital or community treatment
      - Severity of pneumonia
      - Clinical judgement
  - - - Assess for hospital referral
      - Review after 48 hours
        
        No improvement
        
        Chest radiography
        
        Consider hospital admission
        
        Disease severity assessment
    - - Empirical therapy
      - Switch from IV to oral
        
        Amoxicillin + macrolide
        
        Clarithromycin
      - Local issues
        
        Resistance patterns
        
        C. diff associated diarrhoea
  - - - Prior to discharge
  - - - Severity of CAP
      - Treatment in hospital or community
    - - Moderate and high severity CAP
    - - Guided by
        
        Prior antibiotic therapy epidemiological factors
        
        Clinical factors
        
        Age
        
        Co-morbidity
        
        Severity indicators
    - - Sensitivities
      - Blood cultures
      - Urine antigen tests
      - PCR
      - Serology
      - Sputum cultures
      - Sputum Gram stain
  - - - Pneumococcal vaccination
      - Annual influenza vaccination
- - - - Inform severity assessment
    - - HIGH
    - - Consolidation
  - - - Confusion
      - Respiratory Rate
      - Blood pressure
      - 65 years old
      - Urea
  - - - Spitting up material
  - - - Pulse
      - Blood pressure
      - Respiratory rate
      - Mental status
      - Temperature
      - Oxygen saturation
      - Inspired oxygen concentration
        
        At least twice daily
      - No improvement after 3 days
        
        Repeat
        
        CRP
        
        Chest radiograph
      - Review
        
        Within 24 hours of planned discharge