Antimicrobial prescribing: NHS Forth Valley
Important: Therapy
Benzylpenicillin IV + Gentamicin IV for 5-7 days
Second line treatment choice on basis of culture and sensitivity - discuss with microbiology
Notes:
If Gentamicin not suitable - use cefotaxime
Community Acquired Pneumonia - Severe
Micro Organisms
Haemophilus influenza
Staphylococcus aureus
Klebsiella spp
Mycoplasma spp
Important: Therapy
Amoxicillin IV (Add azithromycin PO if atypical pathogen suspected or no response to amoxicillin alone)
Duration: 5-10 days
Escalate to co-amoxiclav IV +/- azithromycin PO if not responding or had amoxicillin in preceding 14 days.
Notes:
Consider IV to oral switch when afebrile > 24 hours and clinically improving.
If MRSA confirmed/suspected add vancomycin IV
Important: Therapy
Ceftriaxone +/- azithromycin PO (if atypical pathogen suspected)
Duration: 5-10 days
(Add azithromycin if atypical pneumonia is suspected or if no response to ceftriaxone alone)
Notes:
Consider IV to oral switch when afebrile > 24 hours and clinically improving.
If MRSA confirmed/suspected add vancomycin IV
Important: Therapy
Vancomycin IV + azithromycin PO
(use IV clarithromycin in place of azithromycin only if unable to tolerate oral)