Community Acquired Pneumonia - Treatment in the Community

Community acquired pneumonia-treatment in the community

BTS 2009

NICE 191

Start antibiotics immediately

Use CRB65 score to guide mortality risk, place of care & antibiotics Each CRB65 parameter scores 1: Confusion (AMT<8); Respiratory rate >30/min;

BP systolic <90 or diastolic ≤60; Age >65;

Score 3-4 urgent hospital admission; Score 1-2 intermediate risk consider hospital assessment; Score 0 low risk: consider home based care.

Always give safety-net advice and likely duration of symptoms. Mycoplasma infection is rare in >65s.

If no reponse to antibiotics after 2 weeks  consider possibility of lung cancer or tuberculosis and arrange chest X-ray. Seek risk factors for Staph aureus and Legionella.