Community-Acquired Pneumonia Essay

Community-Acquired Pneumonia Essay

Community-acquired pneumonia

Provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples. Community-Acquired Pneumonia Essay

Community-acquired pneumonia is the infection of the lungs and the lower respiratory system acquired outside the hospital settings. Microorganisms such as viruses, bacteria, and fungi are the causes of CAP. Bacteria such a streptococcus and pseudomonas are the most common causes of CAP. A patient with CAP presents with a productive cough, fever, chills, and rigors, chest pain, shortness of breath, and difficulties in breathing (Metlay, et al, 2018). Physical examination findings in CAP are coarse crackles, tachypnea, intercostal resection, flaring of nasal alae, and cyanosis. The pharmacological treatment method involves antibiotics, antipyretics, and antihistamine. Supportive management entails giving oxygen when then circulation is less than 90% room air. Community-Acquired Pneumonia Essay

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A combination of beta-lactams and aminoglycosides such as penicillins and gentamycin is the first-line therapy used in the treatment of CAP. This treatment regimen is not appropriate for this patient because he is allergic to penicillin. Second-line treatment entails giving a combination of cephalosporin and a macrolide. Ceftriaxone and azithromycin are the best combinations because they are broad-spectrum antibiotics that stop the growth of bacteria hence stopping the disease process. Ceftriaxone has adverse effects such as nausea and vomiting upon drug administration (Eljaaly, et al, 2019). Azithromycin and ceftriaxone stops the growth of bacteria, including the healthy bacteria thus interfering with the normal flora.

Levaquin is an antimicrobial under the class of quinolones. It is effective for the treatment of acute bacterial pneumonia in adults and children (Buell, et al, 2020). I agree with the use of Levaquin in the treatment of a patient because it is a monotherapy that is easy to compy to. Unlike azithromycin and ceftriaxone, it has rare adverse effects such as headaches. Its mode of action is similar to azithromycin and ceftriaxone. Levaquin is effective in cases of CAP caused by pseudomonas species.

CASE STUDY

Provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples. Community-Acquired Pneumonia Essay

Community acquired pneumonia is the most serious respiratory illness and has the highest mortality rate around the world (Safaa et al., 2021). For this reason, CAP must be taken seriously and treated promptly when identified. The patient in this case study is on day three of his hospital stay and is being treated with ceftriaxone and azithromycin. Although his clinical status has improved, there are a couple of changes I would make to his treatment plan. First of all, due to his penicillin allergy, I would have started him on a five day monotherapy of Levaquin initially. Castelli and Jarrett (2017) state there are no differences in clinical outcomes between five day treatments and longer treatments, and since longer antibiotic treatments only increase chances of antibiotic resistance, increases costs, and increases chances of adverse effects, I would start with a five day treatment. Since ceftriaxone is a cephalosporin, and closely related to penicillin, I would not have taken any chances in the beginning. Mandell (2002) states that the anti-inflammatory properties of fluoroquinolones contribute to their efficacy by reducing the clinical symptoms associated with the immune response.

For this patient’s nausea and vomiting I would start him on ondansetron 4mg 1-2 tabs po every 8 hours as needed. A study conducted by Braude and Crandall (2008) showed that there was no significant difference in the efficacy of ondansetron versus promethazine, and promethazine had a much high sedation rate. For this reason I would choose to prescribe ondansetron first.

References
Braude D, & Crandall C. (2008). Ondansetron versus promethazine to treat acute undifferentiated nausea in the emergency department: A randomized, double-blind, noninferiority trial. Academic Emergency Medicine, 15(3), 209–215. https://doi-org.ezp.waldenulibrary.org/10.1111/j.1553-2712.2008.00060.x

Castelli, G., & Jarrett, J. B. (2017). When to “CAP” off treatment for pneumonia: Is 5 days of antibiotic therapy really sufficient for adults hospitalized with community-acquired pneumonia? Journal of Family Practice, 66(10), 629–631. Retrieved from https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=0&sid=4ef83dbb-05f7-4f95-8e2f-407080421586%40sdc-v-sessmgr03 Community-Acquired Pneumonia Essay

Mandell, L. A. (2002). The potency/efficacy of the fluoroquinolones in community-acquired pneumonia. Formulary, 37(6), 27–31. Retrieved from https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=0&sid=d7a03fb7-f971-4861-92a8-ccffb32b50d5%40sessionmgr4007&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=105529279&db=edb

Safaa, W. Hassan, B., & Shaimaa, A. E. (2021). Adding steroids in severe community-acquired pneumonia treatment: does it make a difference? Egyptian Journal of Chest Disease and Tuberculosis, 70(1), 71–77. https://doi-org.ezp.waldenulibrary.org/10.4103/ejcdt.ejcdt_39_20 Community-Acquired Pneumonia Essay

RUBRIC

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

References

Buell, K. G., & Lander, E. M. (2020). The Risk of Corticosteroids in Community-Acquired Pneumonia. American family physician101(4), 197-197.

Eljaaly, K., Wali, H., Basilim, A., Alharbi, A., & Asfour, H. Z. (2019). Clinical cure with ceftriaxone versus ceftaroline or ceftobiprole in the treatment of staphylococcal pneumonia: a systematic review and meta-analysis. International journal of antimicrobial agents54(2), 149-153.

Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., … & Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. American journal of respiratory and critical care medicine200(7), e45-e67. Community-Acquired Pneumonia Essay

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