Patient Case: Role of Repeat Imaging in CAP
A 75 year old 👵🏿 is hospitalized with radiographically confirmed community acquired pneumonia. She initially required oxygen support but has been treated with 5 days of antibiotics and is ready for discharge 🏡
Should a repeat chest X-ray be ordered to determine if she needs more antibiotics? 🩻
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Best Answer
No - a repeat chest X-ray is not needed.
Explanation: Infiltrates persist on imaging at Day 28 in 47% of patients and may be present up to 12 weeks! Clinical response - rather than radiographic resolution - should be used to determine appropriate length of therapy in CAP. 2019 IDSA CAP Guidelines recommend against routine repeat imaging in patients who are clinically improving. Repeat imaging may be considered in patients who do not respond to treatment or relapse.