Patient HH Is responding to Azithromycin 500mg. IV, and Ceftriaxone 1000 mg IV, which he has been taking for three days. I recommend stopping ceftriaxone and continuing Azithromycin 500 mg. PO for two days and then 250 mg. for two days based on recommendations for the Sanford Guidebook (Gilbert & Chambers 2022). To address the patient’s nausea and vomiting, administer Zofran 4 milligrams IV for the primary dose and give it every six hours as indicated for nausea. Zofran 4mg. can be given orally every 6 hours if tolerated by the patient.
The antibiotic therapy recommendation for patients with favorable clinical response and community-acquired pneumonia is 5-7 days (Regnath & Oba, 2022).
Other considerations for this patient’s case are sputum or blood to identify the infective organism to best tailor antibiotic therapy. Cultures establish a baseline, and repeat cultures indicate the effectiveness of current antibiotic therapy (Kleinpell & Elpern 2004). Literature supports cultures before and after three days of antibiotic therapy.
Oxygen therapy is to be continued until the patient reaches baseline oxygen saturation. Titrating oxygen in the coming days is indicated. In preparation for discharge, this patient should be screened using the CURB-65 tool to determine the safety of treating outpatients (Moskowitz et al., 2019).
Educate the patient regarding the incentive spirometer and why it is indicated. Education on correct usage and follow-up care with the primary health care provider. Educate the patient regarding antibiotics and the importance of medication compliance. Go over the care plan if the patient becomes symptomatic and the drug regimen plan upon discharge.
