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Content Update

March 15, 2023

Inpatient Management of COVID-19: The National Institutes of Health (NIH) frequently release COVID-19 guideline updates to assist with the diagnosis, treatment and management of patients infected with COIVD-19. The management of inpatients with COVID-19 varies greatly depending on patient risk factors, disease severity and medication availability. Pharmacologic treatment involves a variety of therapies that target different pathologic mechanisms including antivirals, anti-inflammatory agents, and immunomodulatory agents, This update will focus on new pharmacotherapy recommendations regarding the inpatient management of COVID-19.

Content Update

September 29, 2022

Approval of the Combination Nirmatrelvir/Ritonavir (Paxlovid™) for the Treatment of COVID-19 in the Outpatient Setting: In December 2021, the treatment combination nirmatrelvir/ritonavir (Paxlovid™) received emergency use authorization (EUA) by the U.S. Food and Drug Administration (FDA) for the treatment of COVID-19 in adults and children over 12 years of age. The combination pill consists of nirmatrelvir, a 3C-like protease inhibitor which inhibits viral replication, and ritonavir, a protease inhibitor with pharmacokinetic boosting effects. Certain patient criteria must be met prior to prescribing. As of July 6, 2022, the EUA was revised giving licensed pharmacists prescriptive authority for the agent.



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

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

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

  3. List the signs and symptoms associated with CAP, HAP, 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, 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 three 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.


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 There are three classifications of pneumonia: community-acquired, hospital-acquired, and ventilator-associated. Patients who develop pneumonia in the outpatient setting and have not been in any healthcare facilities, which include wound care and hemodialysis clinics, have community-acquired pneumonia (CAP). Aspiration was once considered a category of pneumonia, now it should be considered a patient factor for possible anaerobic organism involvement. In addition, healthcare-associated pneumonia was once a category of pneumonia but not any longer. It was defined as pneumonia that develops inside ...

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