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Dc Tr Hc Ca BnhVim Phi Cng ngHung Minh Le PharmD PhD MD
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Ph!n L"#i Vim Phi
Vim $hi m%c $h&i ' cng (ng C"mmuni)*+ac,uire- $neum"nia
Vim $hi m%c $h&i ' .nh /in H"0$i)a1+ac,uire- $neum"nia
Vim $hi m%c $h&i )2 m3* )h' Ven)i1a)"r+a00"cia)e- $neum"nia
Vim $hi 1in ,uan .nh /in Hea1)hcare+a00"cia)e- $neum"nia
Vim $hi -" h4) )h5c 6n 70$ira)i"n $neum"nia
Vim $hi 8h9ng (i:n h;nh 7)*$ica1 $neum"nia
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#i C=ng
Vim $hi> )? 1 )@ /"ng A+ ThEng F&* ra /G" gia mIa 9ng /G (Ju Ku!n
h9ng c NmIaO /im $hi
Q+QR .nh nh!n c nhng .nh m#n )4nh Vim $hi nSng ' ngEi 1n )ui )rU em .nh )rin
min Wchr"nica11* i11X Vim $hi 1G m) )r"ng nhng ngu*n nh!n hGng (Ju nhY$
/in ca ngEi Z[
Tr 1iu \ 0m )r"ng /]ng +Q giE 0au 8hi nhY$ /ingi&m )? 1 )@ /"ng
A
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h))$>^^___`_e.m-`c"m^1ung+cancer^F+ra*+"+a+n"rma1+che0)
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T3c bh!n !* Bnh
\)re$)"c"ccu0 $neum"niae> d[+[ Haem"$hi1u0 in1uenae> A+AQ M"raFe11a ca)arrha1i0> fd
7)*$ica1 $a)h"gen0> Chlamydophila pneumoniae> +d Legionella0$ecie0> in1uena \V $arain1uena a-en"/iru0 dme)a$neum"/iru0
7/24/2019 Vim Phi Cng ng
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Pre-ic)i"n u1e0
CB+[ C"nu0i"n WT!m )hJn 1= m=X + 8h9ng (nh r / ngEi n=i
chjn )hEi gian Urea kl WBb k
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Pneum"nia \e/eri)* qn-eF Ca1cu1a)"r` Decem.er ^^$-a`ahr,`g"/^$0ica1c`a0$
l
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PSI score, assign patients Class I - V
Points total Risk Class Mortality RatesPatient Care
Location
f d q `d su)$a)ien)d )" l qq `[ su)$a)ien)
ld )" R qqq
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VqtM PHqCvb wb
CURB65
iu Tr bg"#i Tr iu Tr bi Tr
Ch6m 0c Sc Bi) WqCX Ch6m 0c ThEng Wn"n+qCX
CB[ x d CB[ Z "$)i"n0 "r C7P
mg $" ,- F A- WTri+$a8X
mg $" -d )hen
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iu Tr bg"#i Tr W))X
Bnh nh!n (} -Ing 8h3ng 0inh )r"ng /]ng A )h3ng
7i)hr"m*cin ~ 7m"Fici11in dgm $" )i- 7ugmen)in K d^[
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iu Tr Bnh Vin ng"Gi qC
d
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iu Tr Bnh Vin ng"Gi qC
qD\7 ui-e1ine WC1in qnec) Di0 \u$$1 \
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iu Tr Bnh Vin ng"Gi qCW))dX
qD\7 ui-e1ine WC1in qnec) Di0 \u$$1 \
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iu Tr Bnh Vin ng"Gi qCW))
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iu Tr Bnh Vin T#i qC
dQ
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iu Tr Bnh Vin qC
Ce)riaF"ne d+
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iu Tr Bnh Vin qCW))dX
P0eu-"m"na0 aerugin"0a c A 1{a chn Ph chjng $neum"c"cca1 /G $0eu-"m"na1 .e)a+1ac)am
Pi$eraci11in^)a".ac)am `g qV , [h "r A`Al ,h Cee$ime d+
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iu Tr Bnh Vin qCW))
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Dc Tr Liu
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Dc Tr Liu
7i)hr"m*cin^C1ari)hr"m*cin Strep. pneumoniae( 8h3ng )6ng c1a/una1a)e ha* g!* ra )iu ch&*
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Dc Tr Liu W))dX
D"F*c*c1ine Chjng Strep. pneumoniaenhng 8h3ng )hujc )6ng -Jn Chjng )j) /i 7)*$ica1 /G Legi"ne11a
z )in /G Tin 1i /; ujng ngG* < 1Jn Tr3nh ch" )rU em fQ )ui /; /Gng r6ng Ph")"0en0i)i/i)*
Penici11in "r V Thujc chn hGng (Ju chjng /im $hi -" S. pneumoniae.
h"&ng R c3c -]ng 1G nh#* c&m /i )hujc MqC "r re0$ira)"r* i0"1a)e0 mi (i )2 `< ug^mL (n
ug^m1
bgun &nh )2 h))$>^^___`ar$an0a`g"/ au^ra-ia)i"n$r")ec)i"n^0"1aria^s1ine^[^
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Dc Tr Liu W)) d+
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Dc Tr Liu W))AX
e0$ira)"r* 1u"r",uin"1"ne0 W1e/"1"Facin m"Fi1"FacinX Ph chjng a)*$ica1 an- )*$ica1 .ac)eria1 $a)h"gen0
Cn )hYn> Tc $r"1"nga)i"n Wnh) 1G /i m"Fi1"FacinX an-ngu* c= . /im ru) -" C. difficile M"Fi1"Facin 8h9ng c $h chjng P0eu-"m"na0 Liu Le/"1"Facin lmg^-
Tr3nh 1iu mg^- WP^PD ineri"ri)*X
bng ( ca 1e/"1"Facin ' $hi^hu*) )hanh>
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Le/"1"FaFin 1iu ca"
Dun.ar LM un-erin8 e) a1` W
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Dc Tr Liu W))X
7m$ici11in^0u1.ac)am Wna0*nX Agm qV ,[h Ph chjng )j) \` $neum"niae an- H` in1uenae nhng
8h9ng )3c -ng /i a)*$ica1 $a)h"gen0`
bu $h&i -Ing )h; cJn $hji h$ /i macr"1i-e "r1u"r",uin"1"ne Tr3nh 8) h$ /i nhm Te)rac*c1ine0
Vim mGng n}"> T? 1 )@ /"ng nhm PCb~Te)ra WlR+QX /0PCb WA+AAX` h9ng c 0{ 8h3c .i) / )? 1 )@ /"ng )r"ng/im $hi`
Ticarci11in^c1a/u1anic aci- WTimen)inX Ticarci11in c $h chjng \` $neum"niae /G a)*$ica1 $a)h"gen0
8h3 8m` !* 1G 0{ 1{a chn 8h9ng ha* 1%m`
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Dc Tr Liu W))X
Vanc"m*cin d mg^8g qV ,Q+d d+
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Dc Tr Liu W))[X
Da$)"m*cin Ph chjng /i \)a$h` 7ureu0 .a" gm M\7 h9ng nn 0@ -ng (: )r /im $hi -" )? 1 )h) .#i ca" bgu*n nh!n> -a$)"m*cin 8) h$ /i 0urac)an) )r"ng .
mS) $hi -n (n gi&m )3c -ng ca )hujc`
A
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Phi
ram ~
Le/"1"Facin sr ")her re0$ira)"r*
Ce)riaF"ne sr Ce)ai-ime
Line"1i-
ram
Le/"1"Facin sr ")her re0$ira)"r*
7m$^\u1 sr Pi$^Ta
r)a$enem
Ad
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h3ng hun W7n)i.i"gramX
h))$>^^___ ch0.ua1"`"rg^"rPh*0ician0^re0"urce0^/en)0^
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h3ng hun W7n)i.i"gramX
h))$>^^___`ch0.ua1"`"rg^"rPh*0ician0^re0"urce0^/en)0^
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h3ng hun W7n)i.i"gramX
A
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h3ng W7n)i.i"gramX
A
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h3ng hun W7n)i.i"gramX
A[
Thai Thu* b` W
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ThEi i:m DIng h3ng \inh
Meehan TP ine M rumh"1 HM e) a1` WdRRl X \ )r 1iu )r"ng /]ng Q giE nhY$ /in gi&m )? 1 )@ /"ng
H"uc8 PM Bra)1er D b0a e) a1`W
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Vai Tr] ca C"r)ic"0)er"i-0
Vai )r] ca c"r)ic"0)er"i-0 )r"ng (iu )r /im $hi 8h9ngr rGng C3c nghin c5u ch" )h* 4ch 1i cha r rGng
\ni-er0 D` Danie10 M -e raa C\ e) a1` W 8h9ng c&i )hin W$o`AQX T? 1 N1a)e ai1ureO Wl< giE 0au 8hi nhY$ /in c )riu ch5ng
)r' 1#iX ca" )r"ng nhm $re-ni0"1"ne dR /0 [ W$o`X LGnh .nh 0au A ngG* nhm -Ing Pre-ni0"1"ne [[ /0
ll> 8h9ng 8h3c .i) W$o`QX
AQ
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ThEi ian Tr Liu
)ji )hi:u ngG* W1e/e1 q e/i-enceXh) 0j) (c Ql< giE /G 8h9ng c h=n d )riu ch5ng)hiu 9n (nh / 1!m 0Gng )rc 8hi ngng )hujc \W1e/e1 qq e/i-enceX
n (nh / 1!m 0Gng bhi) ( xAl`QC bh$ )im x d .ea)0^$h) bh$ )h' x
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Chu*:n )2 qV 0ang Ps
s"0)erheer) B"n)en M e) a1 W
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M) VGi V4 D
d
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Ca0e d
Bb sL l[) c&m )h* 8h )h' (n $h]ng C$ C5u` Bb 1" 1%ng` Th!n nhi) 1n dd`" /G c&m )h* 1#nh run` Tin 0@> (ang h) )hujc 13 mi )uJn d gi` h9ng ujng
ru /G 8h9ng -Ing )hujc .) h$ $h3$ BP dd^lmmHg H R
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Ca0e d
CB+[ C"nu0i"n WT!m )hJn 1= m=X> Urea kl WBb k n^a
Re0$ira)"r* ra)e + bh$ )h' kA 1Jn^$h)> QQ s< .&" h]a
B1""- $re00ure + Hu*) 3$ fR^[ mmHg> Age + Tui Z[> d
Che0) Kra*> F!m nhY$ nhiu .n $hi Ph&i
Tin 0@> h) )hujc 13 bhY$ /in ha* 8h9ng qC ha* 1G n"n+qC
A
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Ca0e d
bhY$ Vin /G" n"n+qC /; 8h3 1n )ui Wl[)X c )in 0@(ang h) )hujc 13 Che0) Kra* F!m nhY$ h=i nhiu
Dc )r 1iu 7i)hr"m*cin mg qV ,
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Ca0e