Community Acquired Pneumonia (CAP)

Duration

Mild – Moderate disease 7 - 10 days.

Mild/Moderate (CURB65 0-2)

PO Amoxicillin  500mg -1g three times daily. (1g if CURB = 2 )

+ / - PO Clarithromycin 500mg 12 hourly ( if CURB = 2)

Consider IV IF CURB = 2 and more clinically severe.

Allergy:

CURB = 2

Doxycycline 200mg on day 1 then 100mg once daily

CURB = 0/1

PO  Clarithromycin 500mg 12 hourly

Severe (CURB65 3-5) or clinically severe pneumonia in young patients

IV Co-amoxiclav  1.2g 8 hourly

+  IV Clarithromycin 500mg 8 hourly

If penicillin allergy IV/PO  Levofloxacin  500mg 12 hourly.

 

Treatment duration 10 days

Severe pneumonia remember urine for pneumococcal & legionella antigen (10ml white topped universal container), blood cultures, sputum. Viral investigations on sputum or viral throat swab, and serology

Notes

See additional guidance for further information (see policy)

Assess CURB 65 score and NHS D & G Clinical handbook/Clinical judgement.