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Community Acquired Pneumonia
Empiric Treatment & Management

Empiric Treatment & Management

Management

Consider treatment modification for patients with complicating factors, such as:

  • Significant lung disease
  • Immunocompromised
  • Colonization with Multi-drug resistant organisms
  • Risk of resistant organisms (i.e. recent antimicrobial therapy or structural lung disease)

Avoid routine use of corticosteroids in adults, unless presenting with refractory septic shock

  • If BioFire® FilmArray® Respiratory Panel screens negative for for common atypical organisms such as Chlamydophila pneumoniae and Mycoplasma pneumoniae, additional coverage for atypical organisms is likely not necessary.
  • Atypical coverage recommended if severe illness (ICU), diffuse or multilobar infiltrates and seasonal pattern (June to October for Legionella) or travel to areas of legionellosis outbreaks

Empiric Treatment

OR

cefTRIAXone 1g IV daily
​

If unable to take PO or severe illness

+/- ATYPICAL COVERAGE

*Atypical Coverage recommended for severe illness (ICU) , diffuse or multilobar infiltrates and seasonal pattern of legionella (June to October ) or travel to areas of Legionellosis outbreaks. *

OR

True SEVERE Beta-Lactam Allergy

Levofloxacin 750mg PO daily
​

If patient unable to swallow or tolerate PO due to gut absorption issues, then IV is an acceptable alternative

Duration

  • 3-5 days
  • Before discontinuing antibiotics, patients should be afebrile for 48 hours

Safely transition to oral therapy once:

  • Hemodynamically stable
  • Improving clinically
  • Afebrile for 24 hrs
  • Can ingest oral meds and have functioning GI tract