Case:
You are called by the emergency department and told of a 72-year-old male nonsmoker with a history of diabetes, coronary artery disease, and hypertension who presents with pneumonia and needs to be admitted to the hospital. The patient is febrile and tachypneic, has a blood pressure of 145/65, and has an oxygen saturation of 95% on room air. Physical examination is significant for rhonchi in the right lower lung fields, and a chest x-ray shows a right lower lobe infiltrate. Laboratory studies show a white blood cell count of 14,000 and no evidence of acute renal failure. Blood cultures have been obtained and an unknown antibiotic has been started in the emergency department.
Questions:
1. Should this patient be admitted to the hospital?
2. What historical information is needed to make a treatment decision for this patient?
3. What is the best initial treatment if this patient has no antibiotic allergies and no significant contact with the health care system?
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I think think this patient will have a curb 65 score of 2 which means he can be admitted to floor or discharged on oral Ab....I just want to get more details about his RR and oxygenation
yes , curb65 , with co morbidities patient needed to be admitted,
Diabetes status
Antibiotic ceftriaxone 20mg/kg in bd dose. Alone or with levoflox750mg.
admit the beacause its high curb 65 so high risk should be getting admitted