Treatment of nursing home-acquired pneumonia.
Pneumonia is an important cause of morbidity and mortality in nursing home residents, with 30-day mortality rates ranging from 10 to 30 percent. Streptococcus pneumoniae is the most common cause of nursing home-acquired pneumonia, although Staphylococcus aureus and gram-negative organisms may be more common in severe cases. Antibiotic therapy for nursing home-acquired pneumonia should target a broad range of organisms, and drug-resistant microbes should be considered when making treatment decisions. In the nursing home setting, treatment should consist of an antipneumococcal fluoroquinolone alone or either a high-dose beta-lactam/beta-lactamase inhibitor or a second- or third-generation cephalosporin, in combination with azithromycin. Treatment of hospitalized patients with nursing home-acquired pneumonia requires broad-spectrum antibiotics with coverage of many gram-negative and gram-positive organisms, including methicillin-resistant S. aureus. Appropriate dosing of antibiotics for nursing home-acquired pneumonia is important to optimize effectiveness and avoid adverse effects. Because many nursing home residents take multiple medications, it is important to consider possible drug interactions.
Mills
Kyle
K
Swedish Medical Center, Englewood, CO 80113, USA. kmills1@uwyo.edu
Graham
A Christie
AC
Winslow
Bradford T
BT
Springer
Kathryn Lee
KL
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D004347:Drug Interactions; D006707:Homes for the Aged; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous; D009735:Nursing Homes; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D017410:Practice Guidelines as Topic
D000900:Anti-Bacterial Agents