Community Acquired Pneumonia - Treatment in the Community | Right Decisions

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Antimicrobial prescribing: NHS Grampian, Orkney & Shetland
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Community Acquired Pneumonia - Treatment in the Community

Announcements and latest updates

Polyfill.io vulnerability

28 june 2024

Our eHealth team advised us yesterday of an international vulnerability relating to polyfill.io . This domain has become compromised and is spreading malware through a widespread supply chain attack, estimated to affect over 110,000 websites including major websites such as the BBC. The Polyfill site offered widely used bits of code for older browsers that allowed the use of modern Javascript features. Such code makes the work for web developers easier and allows compatibility with a broader range of browsers.

Websites that have used the Javascript code from Polyfill have been urged to remove such code immediately. The change occurred after a suspected Chinese firm purchased the domain in early 2024.

Tactuum have identified and are now testing a fix to remove all Polyfill code from the RDS site.. They will be deploying the fix on Monday 1 July along with other planned fixes and amendments. I will notify you of the timing of the deployment as soon as possible.

In the meantime, please ensure that you have up-to-date anti-virus software installed on your machines and personal devices.

NICE - Pneumonia (community-acquired) - antimicrobial prescribing summary

NICE - Pneumonia in Adults

COVID-19 NHS Inform

NICE - COVID-19 rapid guideline: managing COVID-19

Start antibiotics immediately.

Use CRB65 score to assess severity.

Each CRB65 parameter scores 1:

Confusion (AMT≤8); Respiratory rate ≥30/min; BP systolic <90 or diastolic ≤60; Age ≥65;

If no response in 48 hours consider admission.

If CRB 65 = 1 or 2 consider need for hospital admission. If at home, clinically assess need for dual therapy for atypicals.

Drug details

If CRB65=0

Amoxicillin

500mg 3 x daily

5 days

Alternative treatment

If CRB65=0

Doxycycline

(not suitable for those under 12 years)

200mg on Day 1

then 100mg daily

5 days

OR

If CRB65 = 0

Clarithromycin

500mg 2 x daily

5 days

If CRB65=1 or 2 & AT HOME - clinically assess need for dual therapy for atypicals:

Amoxicillin

500mg 3 x daily

5 days

AND (if dual therapy for atypicals required)

Clarithromycin

500mg 2 x daily

5 days

Alternative treatment

If CRB65=1 or 2 & AT HOME

Doxycycline alone

(not suitable for those under 12 years)

200mg on Day 1

then 100mg once daily

5 days