Evidence-based On-call

Community-acquired pneumonia

Therapy

Monitor your patient's response ^c

and repeat investigations if there is no improvement after 72 hours. ^d

Why?

One in seven patients fail to respond to the first antibiotic regimen (14%: 95% CI: 8.6% to 19%) ^c
Pneumococcal pneumonia resistant to penicillins and cephalosporins is becoming more common particularly for patients ^c
- with 2 or more co-morbidities
- aged 65 or more

Old age and multiple co-morbidities increase the risk of antibiotic resistant infection

Outcome ^c	Risk Factor	PEER	OR (95% CI)	NNH (95% CI)
cephalosporin-resistant pneumonia	aged 65 or more not independent	28%	5.0 (1.3 to 18.8)	3 (2 to 5)
penicillin-resistant pneumonia	2 or more co-morbidities not independent	38%	4.7 (1.2 to 19.1)	3 (2 to 23)