What is the standard treatment for outpatients with bacterial pneumonia?

Updated: Sep 30, 2020
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Outpatients are typically treated with oral antibiotics. For the most part, parenteral medications are given to patients admitted to the hospital. This rationale does not preclude the clinician from giving an initial intravenous (IV) dose of antibiotics in the emergency department and then sending the patient home on oral agents, if the patient's condition warrants this action. The patient's condition, infection severity, and microorganism susceptibility should determine the proper dose and route of administration.

A rational approach may be to administer an oral extended-spectrum macrolide or amoxicillin and clavulanate (Augmentin) to those with mild, outpatient disease. Oral fluoroquinolone may be substituted if a comorbid illness or allergy to the first-line agents is present or for good dosing compliance. Admitted patients should receive IV therapy, a third-generation cephalosporin alone or with a macrolide. An alternative regimen would be IV fluoroquinolones alone.


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