What is the appropriate spectrum of antibiotic therapy 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

In otherwise healthy hosts with CAP, therapy does not need to cover S aureus, Klebsiella species, or P aeruginosa. Coverage should include typical (S pneumoniae, H influenzae, M catarrhalis) and atypical (Legionella and Mycoplasma species, C pneumoniae) pathogens. S aureus coverage should be included in patients with influenza who have focal infiltrates or patients who have risk factors for MRSA pneumonia such as prior hospital admission of 2 or more days in the preceding 90 days, antibiotics in the preceding 90 days, residence in a long-term care facility, septic shock at the time of CAP, immunosuppression, enteral tube feedings, nonambulatory status, gastric acid suppression, chronic hemodialysis, congestive heart failure, and history of MRSA colonization. [5, 55]


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