Community acquired pneumonia (CAP)

Antimicrobial prescribing: NHS Grampian, Orkney & Shetland
NHS Grampian

Micro Organisms

Streptococcus pneumoniae

Duration

Mild to moderate - 5 days

Severe - 7 days. May need to extend depending on organisms recovered/suspected.

Mild to moderate

Therapy

Oral Amoxicillin

Notes:

Mild to moderate in penicillin allergy

Therapy

Oral Clarithromycin

Notes:

Severe - Neonates

Therapy

IV Benzylpenicillin
+ IV Gentamicin

Notes:

Severe - Age over 1 month

Therapy

Oral/IV Amoxicillin

Notes:

If not responding after 48 hours consider switching to oral/IV Co-amoxiclav

Severe - Age over 1 month in penicillin allergy

Therapy

Oral/IV Cefuroxime

Notes:

Notes

Samples for viral testing: nasopharyngeal secretions (or nose and throat swabs in viral transport medium), consider acute and convalescent sera.

Collect sputum and blood cultures in pneumonia if complications arise (e.g. empyema, effusion) or if patient requires high dependency care.

Always consider prior therapy; in patients who have not responded to a recent course of antibiotics consider an alternative agent.

Oral therapy should be considered the norm except in patients with complications, severe sepsis or those unable to take oral therapy.