What are the outpatient treatment options for community-acquired pneumonia (CAP)?

Updated: Oct 31, 2019
  • Author: Stephanie L Baer, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

Adequate empiric antimicrobial therapy for CAP includes coverage for S pneumoniae and atypical bacterial pathogens. Outpatient treatment for CAP in patients with no comorbidities and no risk factors for drug-resistant S pneumoniae frequently includes the following: [7]

  • Amoxicillin 1 g PO three times a day OR
  • A macrolide (azithromycin 500 mg once and then 250 mg daily, clarithromycin 500 mg twice daily) OR
  • Doxycycline 100 mg twice daily

Macrolides should be used only in areas where pneumococcal resistance is less than 25%. During influenza season, it is also reasonable to initiate oseltamivir, zanamivir, or baloxavir therapy in outpatients who present with a flulike illness and pneumonia.


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