التهاب الرئة بالهيموفيلوس إنفلونزا في الالتهاب الرئوي المكتسب من المجتمع مع عوامل خطر MRSA المعتمدة محليًا

References

DOI: 10.1164/rccm.201908-1581ST

• We recommend clinicians only cover empirically for MRSA or P. aeruginosa in adults with CAP if locally validated risk factors for either pathogen are present (strong recommendation, moderate quality of evidence).
• The most consistently strong individual risk factors for respiratory infection with MRSA or P. aeruginosa are prior isolation of these organisms, especially from the respiratory tract, and/or recent hospitalization and exposure to parenteral antibiotics.
• Add MRSA coverage and obtain cultures/nasal PCR to allow deescalation or confirmation of need for continued therapy.
• We recommend that the duration of antibiotic therapy should be guided by a validated measure of clinical stability (resolution of vital sign abnormalities [heart rate, respiratory rate, blood pressure, oxygen saturation, and temperature], ability to eat, and normal mentation), and antibiotic therapy should be continued until the patient achieves stability and for no less than a total of 5 days (strong recommendation, moderate quality of evidence).
• As most patients will achieve clinical stability within the first 48 to 72 hours, a total duration of therapy of 5 days will be appropriate for most patients.