Antibiotics for severe community-onset pneumonia Atypical coverage always - Usually azithromycin 500 mg daily - Doxycycline if animal exposure or contraindication to azithromycin Beta-lactam backbone - Usually ceftriaxone (safe for non•anaphylactic penicillin allergy) Consider two grams IV daily esp. in heavier patients. - Risk for pseudomonas: cefepime or piperacillin-tazobactam Septic Shock Structural lung disease (severe COPD, bronchiectasis, cystic fibrosis) Broad-spectrum antibiotics for >7 days in past month Hospitalization for > 1 day in last three months Immunocompromise (e.g. chemotherapy, steroid > I Omg/d) Nursing home resident with poor functional status - History of penicillin anaphylaxis: meropenem - Don't use ceftazidime (poor gram-positive coverage) MRSA coverage? only in selected cases - Linezolid 1 st line 600 mg ql 2hr - Vancomycin #Community #Acquired #Pneumonia #CAP #Antibiotics #Coverage #Management
