Community-Acquired Pneumonia
Streptococcus pneumoniae
HAP/VAP/HCAP
Haemophilus influenzae
Gram-negative bacilli (E. Coli, Klebsiella pneumoniae)
Staphylococcus aureus
Moraxella catarrhalis
Legionella pneumophilia
Chlamydophila pneumoniae
Mycoplasma pneumoniae
Viral (Influenza, parainfluenza, respiratory syncytial virus, metapneumovirus, adenovirus)
these, plus:
pseudomonas aeruginosa
resistant strep pneumoniae
MRSA
Risk for drug-resistant Strep pneumo:
Age < 2 or > 65 years
β-lactam therapy within the previous 3 months
Alcoholism
Medical comorbidities (COPD, CHF, renal or hepatic failure, etc.)
Immunosupressive illness or therapy
Exposure to a child in a daycare center
Risk for Pseudomonas:
Structural lung disease (e.g. bronchiectasis)
Repeated exacerbations of COPD/asthma leading to frequent steroid/abx use
Prior antibiotic therapy
Risk for MRSA:
End-stage renal disease
Injection drug abuse
Prior influenza infection
Prior antibiotic therapy
IDSA/ATS guidelines: Recommended empiric antibiotics for community-acquired pneumonia in adults
This table provides the 2007 recommendations of the Infectious Diseases Society of America and the American Thoracic Society (IDSA/ATS) for reference purposes. Please see the UpToDate text for information about choosing between the different guidelines and about the preferred doses and durations of the individual antibiotics.
CA-MRSA: community-acquired methicillin-resistent Staphylococcus aureus; ICU: intensive care unit.
* Doxycycline may be used as an alternative to a macrolide, but there is stronger evidence to support the use of a macrolide than doxycycline for CAP.
Modified with permission from: Mandell, LA, Wunderink, RG, Anzueto, A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44 Suppl 2:S27. Copyright © 2007 University of Chicago Press.