John, a 65-year-old male, presents with fever, productive cough with purulent sputum, and pleuritic chest pain. He appears to be confused, BUN 23, respiratory rate 31, and SBP 100. Lower lobe infiltrates were detected on chest x-ray.
He has no recent illness or antibiotic use. His COVID-19 test was confirmed negative. After a thorough evaluation, John is diagnosed with community acquired pneumonia. His patient history indicates that he has an allergy to penicillin. As a child he developed a rash when penicillin was administered. Use the guidelines and relevant literature in your topic Resources to discuss the following:
Briefly compare the pneumonia severity index and CURB-65.
Based on John’s presentation, what can you determine using the CURB-65 scoring system?
What bacteria are associated with CAP? How are these bacteria classified? (e.g. gram-positive, gram-negative, atypical, etc.).
Determine an empiric antibiotic treatment regimen for John. In your treatment regimen be sure to include the medication(s), dose, frequency, and intended duration of therapy.
Based on the treatment you prescribed, explain your rational for selecting the antibiotics (e.g., bug-drug coverage).
What are the key adverse effects associated with the medication(s)?
In the event a cephalosporin was included as part of John’s CAP regimen, is his childhood allergy to penicillin relevant? Could there be a problem with cross-sensitivity?
REFRENCES MUST BE WITHIN 5 YEARS
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