Do nursing home residents get HCAP?
Background: Your patient has pneumonia: she is hypoxic, tachypnoeic and pyrexial. You begin oxygen and reach for a drug chart to prescribe some antibiotics. "Hold on," your colleague says, "the lady stays in a nursing home - doesn't she need different antibiotics?" You pause, uncertain. "I don't think we're doing that any more," you reply unconvincingly. But should we? Is HCAP (healthcare-associated pneumonia) still a thing?
What is HCAP? It was introduced and defined in guidelines from the American Thoracic Society / Infectious Diseases Society of America (IDSA) in 2005. They were concerned that the following groups of patients were at higher risk of multi-drug resistant infections and should therefore be treated with broad spectrum antibiotics...
It is fair to say that the concept of HCAP has been controversial from the beginning. Many studies failed to replicate the higher frequency of drug-resistant pathogens in these patient groups, and many have argued that the value of the HCAP concept varies by geographical region. I'll take a look at one representative study from each of these groups below.
For detailed show notes please visit our website: https://the-breach.com
It is Free