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Content Update

August 15, 2019

Baloxavir Approved as Novel Treatment for Influenza: The U.S. Food and Drug Administration approved baloxavir marboxil as a new antiviral treatment for influenza on October 24, 2018. The CDC now recommends baloxavir as one of the four FDA-approved antiviral drugs for treatment of seasonal influenza. Baloxavir is administered as a single dose and works by a novel antiviral mechanism of action on influenza RNA polymerase. It has been shown in randomized controlled trials to be comparable to oseltamivir for reducing duration of flu symptoms and serum viral load when given within 48 hours in cases of uncomplicated influenza. There is not yet sufficient literature on baloxavir’s efficacy or adverse events in patients younger than twelve, pregnant women, or hospitalized patients with more severe disease presentations.

Content Update

March 12, 2019

Updated IDSA Guidelines on Seasonal Influenza: The Infectious Diseases Society of America (IDSA) updated the 2009 clinical practice guidelines for the diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. The document provides new information and recommendations on diagnostic testing, use of antivirals, and testing for antiviral resistance. It also presents evidence on harm associated with routine use of corticosteroids. These updated guidelines should be adopted by all primary care providers.

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. List the common pathogens that cause community-acquired pneumonia (CAP), aspiration pneumonia, ventilator-associated pneumonia (VAP), and hospital-associated pneumonia (HAP).

  2. Explain the pathophysiology of pneumonia and associated host defenses.

  3. List the signs and symptoms associated with CAP and VAP.

  4. Identify patient and organism factors required to guide the selection of a specific antimicrobial regimen for an individual patient.

  5. Design an appropriate empirical antimicrobial regimen based on patient-specific data for an individual with CAP, aspiration pneumonia, HAP, and VAP.

  6. Design an appropriate antimicrobial regimen based on both patient- and organism-specific data.

  7. Develop a monitoring plan based on patient-specific information for a patient with one of the four categories of pneumonia.

  8. Apply the complete Patient Care Process to caring for patients with any type of pneumonia.

  9. Formulate appropriate educational information to be provided to a patient with pneumonia.

  10. Explain prevention of pneumonia via immunization and include who the appropriate patient groups are for receiving the various vaccines.

INTRODUCTION

Pneumonia is inflammation of the lung with consolidation. The cause of the inflammation is infection, which can be caused by a wide range of organisms. Image not available. There are four classifications of pneumonia: community-acquired, aspiration, hospital-acquired, and ventilator-associated. Patients who develop pneumonia in the outpatient setting and have not been in any health care facilities, which include wound care and hemodialysis clinics, have community-acquired pneumonia (CAP). Pneumonia can be caused by aspiration of either oropharyngeal or gastrointestinal contents. ...

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