Pneumonia
Duration of treatment: Community acquired-mild: 7-10days. // Gram negative (usually nosocomial): 3 to 6 weeks. // Staphylococcal: 3 to 4 weeks // Legionella, mycoplasma, chlamydia: 14 to 21 days. // Lung abscess: 4 to 6 weeks. |
Possible therapeutic alternatives |
| Pneumonia: Community acquired. (outpatient therapy) Adult patient |
Common pathogens |
| OUTPATIENT |
| No co-morbidities: |
| Azithromycin 500 mg x1, then 250 mg once daily OR azithromycin 2 gm (XR) x 1 dose (OR) |
| Clarithromycin 500mg orally twice daily or 1gram (XR) orally once daily x 7 days (OR) |
| Doxycycline 100mg orally twice daily |
| Co-morbidities present: |
| Levofloxacin 750 mg once daily x 5 days (OR) |
| moxifloxacin 400mg po qd x 7-10days (OR) |
Azithromycin 500 mg x1, then 250 mg once daily PLUS [ Augmentin XR* 1000/62.5 mg 2 tablets orally twice daily or Cefdinir 300 mg orally twice daily or Cefpodoxime 200 mg orally twice daily or
Cefprozil 500 mg orally twice daily] x 7 days
*AUGMENTIN XR is contraindicated in patients with a creatinine clearance of < 30 mL/min. and in hemodialysis patients |
|
| Community acquired PNEUMONIA - Adult (any age) |
Common pathogens |
| Hospitalized patient: |
| Azithromycin 500mg IV once daily PLUS Ceftriaxone 1 gram q24h (OR)
Azithromycin 500mg IV once daily PLUS
Ertapenem 1 gram q24h (OR)
Monotherapy:
Levofloxacin 750 mg IV/PO once daily (OR)
Moxifloxacin 400mg IV qd. |
| ICU patient (CAP): |
[Ceftriaxone 1-2 grams IV q24h OR
Ampicillin-sulbactam (Unasyn) 1.5-3.0 grams ivpb q6h]
PLUS
[Azithromycin 500mg IV once daily OR Levofloxacin 750 mg IV/PO once daily (OR)
Moxifloxacin 400mg IV qd.]
PLUS
Vancomycin - (patient-specific regimen - trough goal 15-20 mcg/ml) |
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