Conclusion
Per the recommendations, you choose to treat K.P. with a macrolide. You choose azithromycin because Kathy will only have to take it for 5 days; this increases the probability of compliance. You intruct Kathy to take two pills on the first day followed by 1 pill/day for the following 4 days. Because pneuomonia is a serious illness, you write Ms. Peters off of work for the remainder of the week. You ask her to schedule an appointment with her PCP at the beginning of next week for follow-up. You explain that you want to make sure she is doing better; her age can put her more at risk for complications. She asks you if another chest xray should be obtained at her next visit. You explain that an xray is not needed until 6-8 weeks after treatment because it can take awhile for the lungs to recover and appear normal on chest film. You tell her to call your urgent care office if she is not starting to feel better in the next 48-72 hours or if she is getting worse.
The following week, you decide to call Kathy at home to make sure she is doing okay and that she has followed up with her PCP. She states she is feeling a lot better and she just saw her PCP earlier in the day. She thanks you for being such a great clinician and states she will definitely come back to your office if she has an urgent concern down the line!
References
Marrie, T. J. Epidemiology, pathogenesis, and microbiology of community-acquired pneumonia in adults. In D.S. Basow (Ed.), UpToDate. Retrieved from: http://www.uptodate.com.proxy.lib.ohio-state.edu/
McCance, K. L. & Heuther, S. E. (2010). Pathophysiology: The biologic basis for disease in adults and children. St. Louis, MO: Elsevier.
Miskovich-Riddle, L. & Keresztes, P.A. (2006). CAP management guidelines. The Nurse Practitioner, 31(1), 43-53.
Watkins, R. R. & Lemonovich, T.L. (2011). Diagnosis and managment of community-acquired pneuomonia in adults. American Family Physician, 83(11), 1299-1306.
