Pneumonia

Pathogens

Risk for drug-resistant Strep pneumo:

Age < 2 or > 65 years

β-lactam therapy within the previous 3 months

Alcoholism

Medical comorbidities (COPD, CHF, renal or hepatic failure, etc.)

Immunosupressive illness or therapy

Exposure to a child in a daycare center

Risk for Pseudomonas:

Structural lung disease (e.g. bronchiectasis)

Repeated exacerbations of COPD/asthma leading to frequent steroid/abx use

Prior antibiotic therapy

Risk for MRSA:

End-stage renal disease

Injection drug abuse

Prior influenza infection

Prior antibiotic therapy

Treatment

IDSA/ATS guidelines: Recommended empiric antibiotics for community-acquired pneumonia in adults

This table provides the 2007 recommendations of the Infectious Diseases Society of America and the American Thoracic Society (IDSA/ATS) for reference purposes. Please see the UpToDate text for information about choosing between the different guidelines and about the preferred doses and durations of the individual antibiotics.

CA-MRSA: community-acquired methicillin-resistent Staphylococcus aureus; ICU: intensive care unit.

* Doxycycline may be used as an alternative to a macrolide, but there is stronger evidence to support the use of a macrolide than doxycycline for CAP.

Modified with permission from: Mandell, LA, Wunderink, RG, Anzueto, A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44 Suppl 2:S27. Copyright © 2007 University of Chicago Press.