Introduction: Pneumonia is a lung infection caused by microorganisms, transmitted through coughing and inhaling infected droplets. Symptoms include a persistent cough, shortness of breath, fever, and chest pain. Diagnosis involves medical history, chest X-rays, lab tests, and exams. Improved environmental conditions have led to a decrease in pneumonia cases.
Methods: The 88-year-old male patient exhibits symptoms including a persistent cough, fever, and breathlessness, from the aspiration of pathogens from the upper respiratory tract into the lungs. The chest X-ray revealed new opacity in the interstitial lung tissue of the left lower lobe, suggesting a lung infection.
Results: This patient's pneumonia is classified as Community-Acquired Pneumonia (CAP), as it developed within 48 hours of hospitalization. Both influenza A and B and COVID-19 rapid antigen test results were negative. According to the American Thoracic Society, patients with CAP and risk factors for MRSA (Methicillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa should be treated with extended-spectrum antibiotics. Empiric options for P. aeruginosa include piperacillin–tazobactam, cefepime, and meropenem. The doctor prescribed meropenem 1 g intravenous therapy (IV) every 8 hours. Due to the patient’s kidney problems (CrCl: 36 mL/min; estimated glomerular filtration rate (eGFR): 46 mL/min/1.73m²), the dosage should be adjusted to 1 g IV every 12 hours, resulting in a drug-related problem (DRP): overdose.
The patient's CURB-65 score (confusion, uremia, respiratory rate, blood pressure, and age of 65 or older) of 2 indicated the need for inpatient care, making hospitalization appropriate. A comparison using indication, efficacy, safety, adherence, and cost (IESAC) suggests changing to oral ciprofloxacin, which is more effective against P. aeruginosa, has fewer side effects, and is less expensive than levofloxacin.
Conclusions: The goal of therapy is to eliminate the pathogen and prevent complications or recurrence. The therapeutic plan includes completing the full course of antibiotics and monitoring for complications. Patient education emphasizes adherence to the treatment plan for optimal recovery.
