START DATE

University of Maryland
Medical Center

University of Maryland Medical Center

Treatment of Community-Acquired Pneumonia IMPRINT WITH PATIENT’S PLATE BEFORE USING

Patient Admitted to Emergency Department

Pneumonia Diagnosis by Radiograph and Symptoms

< 70 points Pneumonia Severity Index Scoring

Risk Class I Standard Diagnosis Work-Up

Consider Home
Management < 90 points > 90 points
Risk Class II - III Risk Class IV - V

NO
Patient Potential
Candidate for Patient Admitted to Hospital
Home Sputum, culture and sensitivity, Blood Cultures

YES
Gatifloxacin 400mg. qd IV or PO
Cultures NOT needed for OR
outpatient management Ceftriaxone 1 gm. IV or PO qd. Plus
Azithromycin 500 mg. IV or PO qd

First Dose Within 4 h of Presentation to

Emergency Department
Macrolide
Or
Fluoroquinolone
Orally for 7-10 days Criteria for Switching to Oral Therapy:
Able to Eat and Drink and Clinical Improvement

Criteria for Discharge:

Criteria as Listed above for Switch to Oral Therapy
Stable Comorbid Conditions
Normal Oxygenation (Oxygen Saturation>90% with room air)

• Repeat CXR in 6 weeks

• pneumovax and influenza Discharge
Outpatient Antibiotic Treatment for a Total of 7-10 days
10/2000
vaccines if deemed
appropriate
CAP TEAM – UMMS 10/20/02