Community Acquired Pneumonia - Severe | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Forth Valley
Paediatric Antibiotic Guidance - Hospital
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Respiratory Tract Infections
Community Acquired Pneumonia - Severe

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Micro Organisms

Haemophilus influenza

Staphylococcus aureus

Klebsiella spp

Mycoplasma spp

First line - Neonates

Important: Therapy

Benzylpenicillin IV + Gentamicin IV for 5-7 days

Second line treatment choice on basis of culture and sensitivity - discuss with microbiology

Notes:

First line - > 1month to 18 years

Important: Therapy

Amoxicillin IV for 7-14 days (Add Clarithromycin if atypical pneumonia is suspected or if no response to amoxicillin alone)

Escalate to co-amoxiclav IV +/- clarithromycin IV if not responding or had amoxicillin in preceding 14 days.

May need to extend co-amoxiclav to 14-21 days e.g if Staphylococci or gram negative bacilli suspected.

Notes:

Consider IV to oral switch when afebrile > 24 hours and clinically improving.

Second line: mild intolerance or mild skin reaction

Important: Therapy

Cefotaxime +/- clarithromycin IV for 7-14 days

(Add Clarithromycin if atypical pneumonia is suspected or if no response to cefotaxime alone)

Notes:

Consider IV to oral switch when afebrile > 24 hours and clinically improving.

Anaphylaxis (including severe skin reaction) to penicillin / cephalosporins

Important: Therapy

Vancomycin IV + Ciprofloxacin IV/PO

Notes: