Podcast 679: Antibiotics for CAP

<p><strong>Contributor:  Peter Bakes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Community-acquired pneumonia (CAP) is normally stratified into outpatient-candidates vs. inpatient candidates for treatment</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">For outpatient treatment, antibiotic selection is driven by presence or absence comorbid health conditions (chronic lung/kidney/liver disease, DM, immunocompromised state, alcoholism, asplenia)</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">No comorbidities: High dose amoxicillin, doxycycline, azithromycin</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Comorbidities: augmentin, cephalosporin, doxycycline, macrolide with fluoroquinolones as an alternatives</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">For inpatient treatment, standard treatment is a macrolide and 3rd-generation cephalosporin</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Prior MRSA isolate or pseudomonas isolate as well as severe pneumonia are indications for adding MDR organism coverage with vancomycin and anti-pseudomonal coverage</span></li> </ul> </li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581ST</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD</span></em></p> <p> </p> <p><span st