MANAGEMENT OF PNEUMONIA

MANAGEMENT OF PNEUMONIAPRIYATMA KHINCHA

INVESTIGATIONS

SPUTUM MICROSCOPYCOLLECTION >25 NEUTROPHILS / LPF/= 30 BREATHS/MINHYPOTENSION 1 LOBE INVOLVED / RAPID PROGRESSIONRENAL INSUFFICIENCY

COMMUNITYACQUIREDPNEUMONIA

TREATMENTHOSPITALISATION??

PNEUMONIA SEVERITY INDEX (PSI)CURB - 65

PSIcalculates the probability of MORBIDITY AND MORTALITY AMONG THE COMMUNITY ACQUIRED PNEUMONIA PATIENTS.USES DEMOGRAPHICS, ASSOCIATED CO-MORBIDITIES, PHYSICAL EXAMINATION, VITAL SIGNS AND LAB FINDINGSRisk group I Rx at homeRisk group II and III home rx with iv antibiotics or 1 day hospital stayRisk group IV and V inpatient Rx

C CONFUSIONU UREMIA > 7 mmol/LR RESPIRATORY RATE > 30/minB BP < 90/60 mm Hg65 years old / more

IDSA / ATS GUIDELINES FOR EMPIRICAL ANTIBIOTIC THERAPY

SPECIAL CONCERNSPseudomonas aeruginosaB LACTAM + AMINOGLYCOSIDE + ANTIPNEUMOCOCCAL FLUOROQUINOLONELegionella pneumophiliaMACROLIDE /CIPROFLOXACIN + IV RIFAMPICINCA MRSAADD LINEZOLID (600mg IV 12 hrly) OR VANCOMYCIN ( 1 g IV 12 hrly)

SUPPORTIVE TREATMENTRESPIRATORY SUPPORTFLUID AND ELECTROLYTE REPLACEMENTTOTAL PARENTERAL NUTRITIONOTHERSANALGESICSCORTICOSTEROIDSINOTROPICS

PREVENTIONPNEUMOCOCCAL CAPSULAR POLYSACCHARIDE VACCINEINFLUENZA VACCINEFOR NOSOCOMIAL INFECTION SURVEILLANCEEDUCATION & AWARENESSHANDWASHINGGOOD DISINFECTIONCONTROLLED USE OF ANTIBIOTICS

WORLD PNEUMONIA DAYNOVEMBER 2TH

THANK YOU!