Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis is –
Correct Answer: Oral Clarithromycin
Description: Ans. is 'a' i.e., Oral Clarithromycin * As per the recommendations for empirical antibiotic management oral clarithromycin is the Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis.Empirical Antibotic Treatment of Community-Acquired PneumoniaOutpatientsPreviousuly healthy and no antibiotics in past 3 months* A macrolide (clarithromycin (500 mg PO bid) or azithromycin (500 mg PO once, then 250mg qd) or* Doxycycline (100mg PO bid)Comorbidities or antibiotics in past 3 months: select an alternative from a different class.* A respiratory fluoroquinolone or* A b-lactam .* A b-lactam plus a macrolide Inpatients, ICU* A b-lactam (cefotaxime (1-2 g IV q8h), ceftriaxone (2g IV qd), ampicilin-sulbactam (2g IV 48h)] plus* Azithromycin or a fluoroquinolone (as listed above for inpatients, non-ICU)Special ConcernsIf Pseudomonas is a consideration* An antipneumococal, antipseudomonal b - lactam (piperacilin/tazobactam (4-5 g IV q6h), meropenem (lg IV q8h)] plus either ciprofloxacin (400 mg IV q 12h) or levofloxacin (750mg IV qd)* The above b-lactams plus an aminoglycoside * The above b-lactams plus an aminoglycoside plus an antipneumococcal fluoroquinoloneIf CA-MRSA is a consideration* Add linezolid (600 mg IV q 12h) or vancomycin (lg IV q 12h).
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