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Frank Geller is a 76-year-old retired teacher who presents to the outpatient walk-in clinic with symptoms of increased cough with sputum production, fever, and chills. He has a 20 pack-year history of smoking, type II diabetes which is controlled with oral medications, and stage III 
chronic kidney disease. On your assessment of Mr. Gellar, you note a respiratory rate of 26, 
temperature of 99.2 F, posterior chest pain on inspiration, and egophony in the right middle and 
right lower lobes and diagnose him with Community Acquired Pneumonia (CAP). 

 

What are your primary recommendations for antimicrobial therapy, in general, for 
patients with CAP?

2. How would your antimicrobial therapy recommendations change for Mr. Gellar based on his comorbidities?

 

 

You receive a phone call from the microbiology lab that Mr. Geller’s sputum cultures have come 
back positive for H. influenzae on day 2 of treatment with antibiotics. 

 

3. Will your management of this patient change based on these results?

 

4. What are options for treatment in a patient that is allergic to penicillins?

 

5. The patient has impaired renal function. Which of the recommended antibiotics that 
have been talked about in this case need to have their dosing adjusted because of 
decreased renal function? Describe the renal dosing. 

 

SCIENCE
HEALTH SCIENCE
NURSING
NURSING MS NUR 530

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