Empirical ATB for CAP

Question

Empirical antibiotic for Community-acquired pneumonia?

Answer

• OPD no COPD or heart dz.
• Oral macrolide
•  OPD with COPD or heart dz.
• Oral (B-lactam + macrolide/doxy) or (quinolone)
• IPD 
• IPD no COPD or heart dz.
• IV Azithromycin
• IPD with COPD or heart dz.
• IV  (B-lactam + macrolide/doxy) or (quinolone)
• ICU
• no risk for P. aeruginosa
•  IV (B-lactam + macrolide) or (quinolone)
• with risk for P. aeruginosa
• IV Antipseudomonal agent + Aminoglycoside + ciprofloxacin

note
Oral macrolide : Azithromycin, Clarithromycin
Fluoroquinolone : Levofloxacin, Moxifloxacin
Oral B-lactam : Amoxy-clav
IV B-lactam : Cefotaxime, Ceftriaxone
Antipseudomonal agent : Cefipime, Imipenem, Meropenem, Piperacillin-tazobactam