Antimicrobial coverage should be divided against typical and atypical CAP pathogens. During influenza season, it is also reasonable to initiate oseltamivir, zanamivir, or baloxavir therapy in outpatients who present with a flulike illness and pneumonia.
In otherwise healthy hosts with CAP, therapy does not need to cover S aureus, Klebsiella species, or P aeruginosa. Adequate therapy for CAP includes coverage for S pneumoniae and atypical bacterial pathogens. For outpatients without significant comorbidities, monotherapy is recommended. Treatment options for CAP in outpatients with no comorbidities and no risk factors for drug-resistant S pneumoniae include the following:
Amoxicillin 1 g orally three times a day, or
Doxycycline 100 mg twice daily, or
A macrolide (azithromycin 500 mg once and then 250 mg daily or clarithromycin 500 mg twice daily).
Combination therapy with amoxicillin-clavulanate or cephalosporin and a macrolide or doxycycline is recommended for patients with CAP and comorbidities. Alternatively, monotherapy with respiratory fluoroquinolone may be considered in such patients.
Lead Image: Science Source
Medscape © 2021 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Michael Stuart Bronze. Fast Five Quiz: Pneumonia Practice Essentials - Medscape - Nov 03, 2021.