Nursing home-acquired pneumonia: an emergency department treatment algorithm

Curr Med Res Opin. 2004 Aug;20(8):1309-20. doi: 10.1185/030079904125004376.


Nursing home-acquired pneumonia (NHAP) is a leading cause of morbidity, hospitalization, and mortality among older nursing home residents. Too often, these patients are erroneously grouped with cases of community-acquired and hospital-acquired pneumonia. Yet, they differ in terms of most common pathogens, significant underlying disease, impaired functional and cognitive status, and poor nutrition. The NHAP emergency department treatment algorithm presented here shows that an important decision for initial care in the emergency department (ED) is whether the patient should return to the nursing home. This decision often is based on the facility's ability to administer parenteral antibiotics, and care for co-morbidities and complications. Cephalosporins are the foundation of initial treatment of NHAP in the ED, and are combined with other antibiotics in anticipation of the most likely pathogens and treatment variables discussed here. It is hoped the NHAP treatment algorithm will contribute to improved outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Algorithms
  • Anti-Bacterial Agents / therapeutic use
  • Cross Infection / diagnosis
  • Cross Infection / therapy*
  • Emergency Service, Hospital*
  • Homes for the Aged*
  • Humans
  • Nursing Homes*
  • Patient Care / methods
  • Pneumonia, Bacterial / diagnosis
  • Pneumonia, Bacterial / therapy*


  • Anti-Bacterial Agents