You’ll play a role in treating community-acquired pneumonia (CAP)...since it causes over 1 million hospitalizations each year.
Bacterial CAP cases vary. These lung infections can be mild...such as “walking pneumonia”...or severe enough to need ICU care.
Help strategize IV antibiotic logistics to curb inpatient CAP.
Improve CAP antibiotic access for adults. Support stocking ready-to-use doses on adult units...so nurses can easily admin antibiotics.
Suggest storing commercial premix bags (levofloxacin, etc) in care areas. But double-check strengths...bag overwraps tend to look alike.
Work with your pharmacist to stock vial sizes matching common CAP doses (azithromycin 500 mg vials, etc). Let nurses attach them to adapter IV bags on the unit...or pre-attach them in the pharmacy.
Limit risks for grabbing wrong vial sizes in your automated dispensing cabinets. For example, clearly separate different strengths away from each other...or protect them in locked-lidded drawers.
Advocate IV push admin over piggybacks. It conserves fluids...delivers meds faster...and can be done on the unit.
Point out this method only works for certain antibiotics...such as ceftriaxone and ampicillin/sulbactam.
Think ahead by ensuring units have enough diluent vials (sterile water, normal saline, etc) in stock for nurses to prep IV push doses.
Focus on unique aspects in kids. For example, ask about past immunizations during medication histories. Prescribers use this important history to choose initial antibiotics for kids.
Anticipate most kids to get ampicillin or ceftriaxone up front. And expect to see azithromycin...or alternatives (levofloxacin, doxycycline, etc)...added when kids have specific infections.
Keep in mind, most kids’ doses will be made in the pharmacy...since their smaller doses will be dispensed in syringes.
Prevent pediatric syringes from accidentally being given IV push. For example, add “Not for IV push” labels to azithromycin, doxycycline, and levofloxacin syringes...since they are given over at least 1 hour.
Get our chart, Managing Community-Acquired Pneumonia, for more on meds, dosing, and other therapies.
- Bradley JS, Byington CL, Shah SS, et al. Executive summary: the management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011 Oct;53(7):617-30.
- Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67.
- Kuitunen I, Jääskeläinen J, Korppi M, Renko M. Antibiotic Treatment Duration for Community-Acquired Pneumonia in Outpatient Children in High-Income Countries-A Systematic Review and Meta-Analysis. Clin Infect Dis. 2023 Feb 8;76(3):e1123-e1128.
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Chart:
Managing Community-Acquired Pneumonia and Aspiration Pneumonia in Adults
- Technician Tutorial: Automated Dispensing Cabinets and Devices
- Technician Tutorial: Mastering Medication Lists and Histories