HCAP / CAP / HAP
Formal Definition
Pneumonia classification: CAP = community-acquired (from community). HAP = hospital-acquired (≥48h after admission). HCAP = healthcare-associated (recent hospitalizations, dialysis, nursing home).
How It's Used on the Ward
"CAP vs HAP" — determines empiric antibiotic coverage. HAP/HCAP requires broader coverage for resistant organisms.
Example
""Patient admitted from a nursing home with fever, productive cough, and lobar opacity on CXR. This is HCAP — start empiric coverage for MRSA and Pseudomonas, not just community organisms.""
Clinical Context
The distinction matters because HAP/HCAP organisms are more resistant (MRSA, Pseudomonas, extended-spectrum beta-lactamase producers). CAP is covered by fluoroquinolone or beta-lactam + macrolide. HAP/HCAP needs anti-MRSA coverage (vancomycin) and anti-Pseudomonal coverage.