Fast Five Quiz: Pneumonia Practice Essentials

Michael Stuart Bronze, MD


November 03, 2021

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.

Read more on the treatment of CAP.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases articles Community Acquired Pneumonia (CAP) and Bacterial Pneumonia.

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