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*       Treatment Options Empiric

Outpatient                                                                  Inpatient

            Macrolide                                                         IV macrolide                           

            Doxycycline                                                      IV doxycycline

            Fluoroquinolone                                                IV fluoroquinolone

            Beta-lactam + macrolide                                   IV beta-lactam + macrolide

            Beta-lactame/lactamase + macrolide                 IV beta-lactame/lactamase +

macrolide

IV vancomycin

IV linezolid

 

Which agents are most commonly used, here are some, generally 7-10 days?

Clarithromycin                                                              Ampicillin/sulbactam

Azithromycin    (PO/IV)                                               Cefuroxime (PO/IV)

Levofloxacin (PO/IV)                                                   Amoxacillin/clavulanate            

Gatifloxacin (PO/IV)                                                     Ceftriaxone

Moxifloxacin                                                                 Cefotaxime

 

*       Definitive Therapy

*       Streptococcus pneumoniae (pneumococci)

 

·        What is the penicillin MIC?

                  < 0.06 mcg/ml penicillin susceptible PCNS would be DOC here

                  0.1 – 1.0 mcg/ml penicillin intermediate High dose PCNS only

                  >2.0 mcg/ml penicillin resistant

 

·        Treatment if resistant depending on the level or resistance

Ceftriaxone

Cefotaxime

Cefuroxime

Levofloxacin

Gatifloxacin

Moxifloxacin

Vancomycin

Linezolid

 

*       Haemophilus influenzae

 

 

*       Mycoplasma pneumoniae

 

 

*       Chlamydia pneumoniae

 

 

*       Legionella pneumophila and spp.

 

 

 

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