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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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