ToolsCalculators
Drug Resistance in Pneumonia (DRIP) Score
Predicts risk of drug-resistant pathogens in community-onset pneumonia.
Drug Resistance in Pneumonia (DRIP) Score
Antibiotic use within the previous 60 days
Residence in a long-term care facility
Tube feeding
Prior infection with a drug-resistant pathogen (within 1 year)
Hospitalisation within the previous 60 days
Chronic pulmonary disease
Poor functional status (non-ambulatory)
Gastric acid-suppressing agent use
Chronic wound care
Known MRSA colonisation (within 1 year)
Result0 points
Score <4: low risk of a drug-resistant pathogen; standard CAP therapy is reasonable.
When to use
- Deciding whether empiric antibiotics for community-onset pneumonia should cover drug-resistant pathogens (e.g., MRSA, Pseudomonas).
Formula
4 major risk factors worth 2 points each (antibiotics in the last 60 days, long-term care residence, tube feeding, prior drug-resistant pathogen within 1 year) plus 6 minor risk factors worth 1 point each (hospitalisation in the last 60 days, chronic pulmonary disease, poor functional status, gastric acid suppression, chronic wound care, MRSA colonisation within 1 year). Range 0-14; >=4 predicts drug-resistant pneumonia with sensitivity ~82% and specificity ~81%.
Pearls and pitfalls
- Outperformed the older HCAP (healthcare-associated pneumonia) criteria for predicting drug resistance in the derivation and validation cohorts.
- Intended to reduce unnecessary broad-spectrum antibiotic use in patients who do not meet the resistance threshold.