Infectious Disease Compendium

Formula

The formula for calculating Creatinine Clearance is((140-age)*(ideal body weight in kg)) /((serum creat)*(72)) for men;times 0.85 for a female.If they are enormously obese use your own fudge (low fat I hope) factor. I like to add an additional 20% to compensate my ideal body weight.

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Male Female Age: Cr:

Wgt: lbs kg



Calculated CrCl:


28) Community-Acquired Pneumonia severity calculator from NEJM Volume 336:243-250 January 23, 1997 Number 4.

A Prediction Rule to Identify Low-Risk Patients with Community-Acquired Pneumonia Michael J. Fine et al. Risk in CAP patients: The risk factors and how they are scored

EXCLUSION CRITERIA: HIV/AIDS, chronically immunosuppressed, known iv drug use, hospitalization within 10 days, homeless or no phone, pregnant, unable to use oral medication, severe psychosocial problems, known pregnancy, current nursing home resident, severe neuromuscular disease, O2 sat<90% or pO2<60 or chronically O2 dependent.

  Patient Characteristic Points Assigned
Demographic Factors (Age) Males Age (in years)
Females Age (in years) -10
Nursing home residents +10
Comorbid Illnesses Neoplastic disease +30
Liver disease +20
Congestive heart failure +10
Cerebrovascular disease +10
Renal disease +10
Physical Examination Findings Altered mental status +20
Respiratory rate 30 breaths per minute or more +20
Systolic blood pressure < 90 mm Hg +20
Temperature < 35°C or 40°C or more +15
Pulse 125 beats per minute or more +10
Laboratory findings pH < 7.35 +30
BUN > 10.7 mmol/L +20
Sodium less than 130 /L +20
Glucose > 13.9 mmol/L +10
Hematocrit < 30 percent +10
Partial pressure of arterial oxygen < 60 mm Hg +10
Pleural effusion +10
< 90, can treat as outpatient, > 90 admit.
Risk Class Score Mortality
Low I 51 0.1%
Low II 51 - 70 0.6%
Low III 71 - 90 0.9%
Medium IV 90 - 130 9.5%
High V > 130 26.7%

Hospitalization is recommended for class IV and V.Class III should be based on clinical judgment. Needs Javascript enabled in your browser.


A bedside scoring system ("Candida score") for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. From Crit Care MedicineVol 34(3)2006 pg 730.

"A Candida score > 2.5 accurately selects patients who would benefit from early antifungal treatment."

TPN: Yes No

Multifocal colonization: Yes No

Surgery: Yes No

Severe Sepsis: Yes No

Candida Score: .

If the number is > 2.5, consider an antifungal.

Candida score=(.908*tpn)+(1.112*colonization)+(.997*surgury)+(2.038*sepsis). In this study, a central lines were not a risk factor.


A Clinical Pulmonary Infection Score Calculator modified from "Short-course Empiric Antibiotic Therapy for Patients with Pulmonary Infiltrates in the Intensive Care Unit" Am J Respir Crit Care Med Vol 162. pp 505–511, 2000. Full text available online, just paste the title into PubMed or google.

A score > 6 at baseline or at 72 h is considered suggestive of pneumonia. If <= 6 at 72 hours patient probably doesn't have pneumonia and antibiotics probably can be stopped.

Temperature (C)

>= to 36.5 and, or equal to 38.4 ................ 0 point

>= to 38.5 and, or equal to 38.9................. 1 point

>= to 39 and, or equal to 36...................... 2 points

Blood leukocytes, mm3

>= 4,000 and, <= to 11,000...................... 0 point

<4,000 or > 11,000.................................... 1 point and

if band forms >= to 50%...................... 1 point

Tracheal secretions

Absence of tracheal secretions...................... 0 point

Presence of nonpurulent tracheal secretions ... 1 point

Presence of purulent tracheal secretions......... 2 points

Oxygenation

PaO2/FIO2, mm Hg >240 or ARDS (ARDS defined as PaO2/FIO2 <= equal to 200, pulmonary artery wedge pressure <= to 18 mm Hg and acute bilateral infiltrates)..... 0 point

<= equal to 240 and no ARDS........... 2 points

Pulmonary radiography

No infiltrate................................................ 0 point

Diffuse (or patchy) infiltrate.......................... 1 point

Localized infiltrate........................................ 2 points

Progression of pulmonary infiltrate

No radiographic progression ........................ 0 point

Radiographic progression (no CHF or ARDS).. 2 points

Culture of tracheal aspirate

Pathogenic bacteria cultured in rare or light quantity or no growth.. 0 points

Pathogenic bacteria cultured in moderate or heavy quantity............ 1 point

Same pathogenic bacteria seen on Gram stain, add 1 point............. 1 point

Notes: CPIS at baseline is assessed on the basis of the first five variables, i.e., temperature, blood leukocyte count, tracheal secretions, oxygenation, and character of pulmonary infiltrate. CPIS at 72 h is calculated based on all seven variables and took into consideration the progression of the infiltrate and culture results of the tracheal aspirate. A score > 6 at baseline or at 72 h is considered suggestive of pneumonia.