• Robert R Muder, Richard V Aghababian, Mark B Loeb, Jerald A Solot, and Martin Higbee.
• University of Pittsburgh and Division of Infectious Diseases, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA. Robert.Muder@med.va.gov
• Curr Med Res Opin. 2004 Aug 1;20(8):1309-20.

AbstractNursing home-acquired pneumonia (NHAP) is a leading cause of morbidity, hospitalization, and mortality among older nursing home residents. Too often, these patients are erroneously grouped with cases of community-acquired and hospital-acquired pneumonia. Yet, they differ in terms of most common pathogens, significant underlying disease, impaired functional and cognitive status, and poor nutrition. The NHAP emergency department treatment algorithm presented here shows that an important decision for initial care in the emergency department (ED) is whether the patient should return to the nursing home. This decision often is based on the facility's ability to administer parenteral antibiotics, and care for co-morbidities and complications. Cephalosporins are the foundation of initial treatment of NHAP in the ED, and are combined with other antibiotics in anticipation of the most likely pathogens and treatment variables discussed here. It is hoped the NHAP treatment algorithm will contribute to improved outcomes.

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