Dora E. Wiskirchen, PharmD, BCPS
PHCY 836 – Day 5 PM
Learning Objectives
Identify risk factors for the development of pneumonia.
Explain the pathophysiology, signs and symptoms, most common bacterial etiologies and associated resistance patterns, severity of illness scoring systems, and diagnostic techniques for pneumonia.
Define atypical pneumonia and characterize patients who may be at risk for developing this type of pneumonia.
Evaluate pharmacologic therapies used for the empiric and definitive treatment of community acquired pneumonia by identifying the appropriate dose, adjustments for hepatic and renal impairment, duration of therapy, adverse events, contraindications, effectiveness, and monitoring parameters.
Differentiate between currently approved fluoroquinolones and macrolides in terms of the antimicrobial spectra in the treatment of pneumonia.
Select an appropriate antimicrobial regimen for the treatment of community acquired pneumonia based on clinical practice guidelines and other peer reviewed literature when given a patient case.
CAP Clinical Practice Guidelines
Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clin Infect Dis 2007;44:S27-72.
Lower Respiratory Tract Infections
Lower Respiratory Tract
Tracheobronchial Tree
Lung parenchyma
Infections
Bronchitis
Bronchiolitis (RSV)
Pneumonia
Community-acquired
Healthcare-associated
Hospital-Acquired
Ventilator-associated
Pathophysiology
Occur when host defenses are hindered or overwhelmed
Humoral immunity, cellular immunity, anatomic mechanisms
Inoculation
Most common: colonization of upper airways, high concentrations, aspiration of oropharyngeal secretions
Less common: via blood from an extrapulmonary source, or inhalation of infected aerosolized particles
Epidemiology of Pneumonia