Emergency Medical Minute9 Jun 2021

Podcast 679: Antibiotics for CAP

Contributor: Peter Bakes, MD

Educational Pearls:

Community-acquired pneumonia (CAP) is normally stratified into outpatient-candidates vs. inpatient candidates for treatment
For outpatient treatment, antibiotic selection is driven by presence or absence comorbid health conditions (chronic lung/kidney/liver disease, DM, immunocompromised state, alcoholism, asplenia)
- No comorbidities: High dose amoxicillin, doxycycline, azithromycin
- Comorbidities: augmentin, cephalosporin, doxycycline, macrolide with fluoroquinolones as an alternatives
For inpatient treatment, standard treatment is a macrolide and 3rd-generation cephalosporin
- Prior MRSA isolate or pseudomonas isolate as well as severe pneumonia are indications for adding MDR organism coverage with vancomycin and anti-pseudomonal coverage

References

Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581ST

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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