Peer Responses: Length: A minimum of 275 words per post, not including reference

Peer Responses:
Length: A minimum of 275 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
Pneumonia is inflammation and consolidation of lung tissue most commonly caused by bacterial pathogens and it is not uncommon to see acute viral and bacterial pneumonia simultaneously (Cash et al., 2021). Bacterial pneumonia is most prevalent in the very young and very old, placing it as the leading cause of death in patients over 65. The most common cause of bacterial pneumonia is S. pneumoniae followed by H. influenzae type B. In children, the most common cause is M. pneumoniae (Cash et al., 2021).
One of the most challenging themes I have within clinical is determining the severity of the patient to base treatment off. The 23-year-old with no comorbidities will be treated entirely different than a 66-year-old with concurrent comorbidities (Cash et al., 2021). For these patients, first, differentiation needs to be made rather outpatient or inpatient treatment is needed. In the 23-year-old’s uncomplicated case, this should be an outpatient basis, but the 66-year-old could very quickly become inpatient criteria based on a number of factors. One tool that can help the provider determine if patients need inpatient treatment for pneumonia is the CURB-65 score. It can be found on the MD Calc App that factors in confusion, BUN >19, respiratory rate 30 or more, blood pressure less than 90 systolic or less than or equal to 60 diastolic, and over 65 years as points to calculate the risk of 30-day mortality. A recommendation is made for outpatient treatment all the way to inpatient ICU treatment based on the 30-day mortality risk. This tool can be applied with clinician judgment to determine the best course of treatment for the patient (Cash et al., 2021).
One tool I have found extremely helpful when determining appropriate antibiotic therapy is the EMRA Antibiotic Guide (Levine, 2022). It presents most diseases requiring antibiotics and offers both outpatient simple, outpatient complication, inpatient simple, and inpatient complicated antibiotic suggestions. For the above patients, if both are meeting criteria for outpatient therapy, the 23 year old could be treated with amoxicillin 1g PO TID for 5 days or if compliance issues would be suspected a Azithromycin 500mg PO day one then 250mg PO daily for 4 more days. Due to the 66 year old’s comorbidities Augmentin plus azithromycin would be an acceptable treatment plan with close follow up to monitor for improvement (Levine, 2022).