In community acquired pneumonia out patient treatment Is: (PGI June 2007)
Correct Answer: Azithromycin
Description: Ans,: A (Azithromycin) As Q is mentioned only simple community acquired pneumonia (Not MRS A or Pseudomonas; so aminoglycosides & vancomycin are not given in answer), so give outpatient treatment given in Harr/son tableTable (Harrison 17th/1623): Empirical Antibiotic Treatment of Community'-Acquired PneumoniaOutpatientsPreviously healthy and no antibiotics in past 3 monthsA macrolide orDoxycycline (100 mg PO bid)Comorbidities or antibiotics in past 3 months: select an alternative from a different classA respiratory' fluoroquinolone orAb lactam plus a macrolideQIn regions with a high rate of "high-level" pneumococcal macrolide resistance/ consider alternatives listed above for patients with comorbidities.Inpatients, non-ICUA respiratory fluoroquinolone , gemifloxacin (320 mg PO od), levofloxacin (750 mg PO or IV od)]A biactam' plus a macrolidet Inpatients, ICUA biactam' (cefotaxime (1-2 g IV q8h), ceftriaxone (2 g IV od], ampicillin-sulbactam (2 g IV q8h}] plusAzithromycin or a fluoroquinolone (as listed above for inpatients. non-ICU)Special concernsIf Pseudomonas is a considerationAn antipneumococcal, antipseudomonal p lactam plus either ciprofloxacin (400 mg IV ql2h] or levofloxarin (750 mg IV od)The above piactams plus an aminoglycoside The above piactamsf plus an aminoglycoside plus an antipneumococcai fluoroquinoloneIf Community acquired -SIRSA is a considerationAdd Einezolid (600 mg IV ql2h) or vancomycin (1 g IV ql2h)
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