Community Acquired Pneumonia Test
|Questions with Complete Solutions
What is the first line treatment for CAP in patients requiring hospitalization in the ICU?
- Ans 1. beta lactam (cefotaxime, ceftriaxone, or Unasyn) plus azithromycin or
respiratory fluoroquinolone (moxifloxacin or levofloxacin)
*patients with penicillin allergy use aztreonam
*if covering for MRSA add linezolid or vancomycin
What is the dosing for azithromycin when treating CAP? - Ans Oral: 500mg on day
1 followed by 250 mg once daily for 2-5 days
IV: 500mg daily
*increasing concerns for resistance when used as monotherapy
What are the ADRs for azithromycin? - Ans 1. diarrhea
2. nausea
3. pruritus, rash
4. QTc prolongation
What is the dosing for levofloxacin when treating CAP? - Ans Oral/IV: 500mg daily for
7-14 days or 750mg daily for 5 days
, *requires renal dose adjustment
What is the dosing for moxifloxacin when treating CAP? - Ans Oral/IV: 400mg daily
*no dose adjustments needed
*does not penetrate the urine
What is the coverage of the respiratory fluoroquinolones? - Ans 1. atypicals
2. strep. pneumo
3. pseudomonas (levo)
4. H. influenzae
5. anaerobes (moxi)
Why do we not use ciprofloxacin for pneumonia? - Ans doesnt cover for
strep. pneumoniae
What are the ADRs for fluoroquinolones? - Ans 1. photosensitivity
2. QTc prolongation
3. CNS effects in elderly
4. dysglycemia
5. tendon rupture
6. exacerbations of MG
7. avoid taking with polyvalent cations because will bind and reduce bioavailability
-2 hours before or 6 hours after
What is the dosing for doxycycline to treat CAP? - Ans Oral/IV: 100mg
BID *avoid milk and polyvalent cations
|Questions with Complete Solutions
What is the first line treatment for CAP in patients requiring hospitalization in the ICU?
- Ans 1. beta lactam (cefotaxime, ceftriaxone, or Unasyn) plus azithromycin or
respiratory fluoroquinolone (moxifloxacin or levofloxacin)
*patients with penicillin allergy use aztreonam
*if covering for MRSA add linezolid or vancomycin
What is the dosing for azithromycin when treating CAP? - Ans Oral: 500mg on day
1 followed by 250 mg once daily for 2-5 days
IV: 500mg daily
*increasing concerns for resistance when used as monotherapy
What are the ADRs for azithromycin? - Ans 1. diarrhea
2. nausea
3. pruritus, rash
4. QTc prolongation
What is the dosing for levofloxacin when treating CAP? - Ans Oral/IV: 500mg daily for
7-14 days or 750mg daily for 5 days
, *requires renal dose adjustment
What is the dosing for moxifloxacin when treating CAP? - Ans Oral/IV: 400mg daily
*no dose adjustments needed
*does not penetrate the urine
What is the coverage of the respiratory fluoroquinolones? - Ans 1. atypicals
2. strep. pneumo
3. pseudomonas (levo)
4. H. influenzae
5. anaerobes (moxi)
Why do we not use ciprofloxacin for pneumonia? - Ans doesnt cover for
strep. pneumoniae
What are the ADRs for fluoroquinolones? - Ans 1. photosensitivity
2. QTc prolongation
3. CNS effects in elderly
4. dysglycemia
5. tendon rupture
6. exacerbations of MG
7. avoid taking with polyvalent cations because will bind and reduce bioavailability
-2 hours before or 6 hours after
What is the dosing for doxycycline to treat CAP? - Ans Oral/IV: 100mg
BID *avoid milk and polyvalent cations