Title: Add Atypical Coverage for Healthcare-Associated Pneumonia Patients<br/>Author: Bryan Hayes<br/><a href='http://umem.org/profiles/faculty/369/'>[Click to email author]</a><hr/><p>
In a potentially ground breaking study of healthcare-associated pneumonia (HCAP) patients, atypical pathogens were identified in <u><strong>10%</strong></u> of cases!</p>
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Application to clinical practice: <u><strong>Add atypical coverage</strong></u> with a macrolide or respiratory fluoroquinolone for HCAP patients who have been in the community for any length of time.</p>
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The study also identified HCAP patients who may not require 3 'big gun' broad-spectrum antibiotics. This is a practice changing article for ED providers. For more analysis of the study, please note the bonus reading links below.</p>
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<u>Bonus reading</u>:</p>
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Dr. Emily Heil (<a href="https://twitter.com/emilylheil">@emilylheil</a>) analyzes the full study in more depth at Academic Life in Emergency Medicine: <a href="http://academiclifeinem.com/new-treatment-strategy-not-so-sick-health-care-associated-pneumonia/">http://academiclifeinem.com/new-treatment-strategy-not-so-sick-health-care-associated-pneumonia/</a></p>
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Dr. Ryan Radecki (<a href="https://twitter.com/emlitofnote">@emlitofnote</a>) critiques the study at Emergency Medicine Literature of Note: <a href="http://www.emlitofnote.com/2013/10/down-titrating-antibiotics-for-hcap.html">http://www.emlitofnote.com/2013/10/down-titrating-antibiotics-for-hcap.html</a></p>
<fieldset><legend>References</legend>
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Maruyama T, et al. A new strategy for healthcare-associated pneumonia: a 2-year prospective mulitcenter cohort study using risk factors for multidrug-resistant pathogens to select initial empiric therapy. <em>Clin Infect Dis</em> 2013;57(10):1373-83. [<a href="http://www.ncbi.nlm.nih.gov/pubmed/23999080">PMID 23999080</a>]</p>
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<strong>Follow me on Twitter (<a href="https://twitter.com/PharmERToxGuy">@PharmERToxGuy</a>)</strong></p>
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