Hospital-acquired Pneumonia
| Overview |
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- Hospital-acquired Pneumonia (HAP) is a sub-categorization of Pneumonia and is defined as development of pneumonia more than 2 days after hospital admission. A significant risk factor for Hospital-acquired Pneumonia is the usage of mechanical ventilation.
| Etiologies |
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- Staphylococcus aureus, with special concern for Methicilin Resistant S. aureus (MRSA)
- Pseudomonas aeruginosa
- Enteric Gram Negative Rods:
| Clinical Consequences |
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- The clinical consequences of HAP are very similar to those of Typical community-acquired pneumonia (See page) with high fevers and increased elaboration of purulent respiratory secretions.
- MRSA pneumonias typically progress very rapidly, patient's are extremely ill-appearing, and can rapidly yield empyema and septic shock
| Treatment |
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- Treatment of HAPs is very similar to that of CAPs (third generation cephalosporin plus azithromycin) except with the addition of vancomycin to cover MRSA. If suspicion for pseudomonas is high an anti-pseudomonal penicillin such as pipericillin-tazobactam (zosyn) is substituted for the third generation cephalosporin.