Pharmacologic Therapy for CAP

® Treatment of CAP is predominantly empiric, that is, treatment is started without knowing the causative pathogen. As a way of incorporating an evidence-based approach to antibiotic selection, several different organizations have generated guidelines for the treatment of bacterial or atypical CAP in adults. The most recent guidelines are the result of a collaboration between the IDSA and the ATS.28 The approach to patient care is based on the classification of patients into two broad categories, outpatient and inpatient, and then further divide the groups by comorbid conditions and location in the hospital, respectively. These guidelines use patient-specific data along with predominant pathogen information to design appropriate empirical antimicrobial regimens. Table 71-3 summarizes these therapeutic options. If influenza virus is the cause, supportive care is the best medical intervention available; antiviral agents against influenza are not very effective.

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