Singh et al used a protocol for managing a patient in the intensive care unit (ICU) with a pulmonary infiltrate. This allowed a significant percentage of patients to be managed with a short course of antibiotics. The authors are from the Veterans Affairs Medical Center and University of Pittsburgh.
Patient selection: VA patient in the intensive care unit with a pulmonary infiltrate
Parameters:
(1) baseline Clinical Pulmonary Infection Score (CPIS) of Pugin et al
(2) CPIS at day 3
CPIS at Baseline
Antibiotic Therapy
> 6
treat for 10-21 days
<= 6
start on ciprofloxacin
A patient at low risk at baseline is re-evaluated on day 3.
CPIS on day 3
Antibiotic Therapy
> 6
treat for another 7-18 days
<= 6
stop ciprofloxacin
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