The Pneumonia Formerly Known as HCAP

is admitted to the

for NON-SEVERE pneumonia. She lives in a nursing home but has not been hospitalized or received antibiotics within the last 2 years.

What organism(s) should her antibiotic regimen EMPIRICALLY cover?

A. S. pneumoniae
B. MRSA
C. P. aeruginosa
D. All of the above

How did others respond?

Reveal the answer

Best Answer:

S. pneumoniae

Explanation: This patient meets the OLD criteria for the retired category of HCAP or healthcare-associated pneumonia. Broader coverage for MRSA and P. aeruginosa was commonly recommended for HCAP but in many places these infections were rare. 🦄

2019 ATS/IDSA Guidelines recommend more judicious coverage of MRSA & P. aeruginosa. In non-severe CAP a beta-lactam + macrolide are appropriate for most patients!

The recently published IDSA CAP Clinical Pathway suggests pathogen specific coverage in non-severe CAP in these scenarios:

MRSA: known colonization/respiratory infection 🦠

P. aeruginosa: advanced structural 🫁 disease, known colonization/infection in last 1 year 🦠

It’s time to let go of HCAP!