Table 1 Empirical antibiotic therapy scheme for Community Acquired Pneumonia in the main international guidelines
| Â | Outpatients | Inpatients | ICU-patients | ||
|---|---|---|---|---|---|
ICDS/ATS 2007 Guideline | Previously Healthy | Macrolide Doxycycline | Respiratory Fluoroquinolones Or β-Lactam plus macrolide | No pseudomonas risk factors | Β-Lactam (Cefotaxime, ceftriaxone or ampicillin-sulbactam) plus azithromycin or Respiratory fluoroquinolones. For penicillin-allergic patients, a respiratory fluoroquinolones and aztreonam. |
Comorbidities | Fluoroquinolones or βLactam plus macrolide | Risk factor for P aeruginosa | Antipneumococcal, antipseudomonal β lactam (piperacillin-tazobactam, cefepime, imipenem or meropenem) plus ciprofloxacin or levofloxacin (750 mg) Or plus aminoglycoside and azithroycin | ||
BTS 2009 (Update NICE 2015) | Amoxicillin 500 mg TID OR Clarithromycin (Alternative if Hypersensitive) | Amoxicillin and Macrolide OR Macrolide (Alternative if Hypersensitive) OR Doxycicline OR Levofloxacin or moxifloxacin | Broad spectrum β lactamase antibiotic plus macrolide Second or third generation cephalosporin, if hypersensitivity to β lactam, plus clarithromycin | ||
ERS/ESCMI 2011 | Amoxicillin or Tetracycline Tetracycline or macrolide Alternative Levofloxacin or moxifloxacin (Alternative if hypersensitivity in countries with high incidence of macrolide resistant pneumococcus) | Aminopenicillin plus macrolide Aminopenicillin/β lactamase inhibitor plus macrolide Non antipseudomonas cephalosporin plus macrolide Levofloxacin Moxifloxacin Penicillin G plus macrolide | No pseudomonas risk factors | Non antipseudomonal cephalosporin III plus macrolide Or Moxifloxacine or levofloxacin plus non antipseudomonas cephalosporin III | |
Risk factor for P aeruginosa | Antipseudomonal cephalosporin or acylureidopenicillin/βlactamase inhibitor or CarbapenemPlus Ciprofloxacin or Plus Macrolide plus Aminoglycoside | ||||