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afya Pneumonia: community-acquired

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20160425222522 Ben  
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''Management'' 
//CRB-65// criteria of severity - 3+ of ... (1 and 2 also inc risk of death)
    Confusion (abbreviated mental test score <= 8/10)
    Respiratory rate >= 30 / min
    BP: systolic <= 90 or diastolic <= 60 mmHg
    age >= 65 years
with Urea >7mmol/l if available
//Antibiotics//
    oral amoxicillin (with macrolide if admitted)
    IV benzylpenicillin + clarithromycin/doxycycline if severe (BNF)
    if life threatening (or severe according to BTS) - IV co-amoxiclav/cefuroxime/cefotaxime + clarithromycin

''Features of pneumococcal pneumonia''
    rapid onset
    high fever
    pleuritic chest pain
    herpes labialis

''Common organisms ...''
    Streptococcus pneumoniae - 80% cases
    Haemophilus influenzae
    Staphylococcus aureus - esp after flu - so give fluclox as well as amoxil
    atypical pneumonias  - e.g. Mycoplasma pneumoniae
    viruses
Klebsiella pneumoniae classic in alcoholics