Comments from the Expert Advisory Committee
- Assess using the CRB-65 score (Confusion, Respiratory rate ≥ 30/min, BP ≤90/60, Age ≥ 65)
- Start antibiotics immediately
- Avoid tetracyclines in pregnancy.
- Low doses of penicillins are more likely to select out resistance.
- The quinolones ciprofloxacin and ofloxacin have poor activity against pneumococci. However, they do have use in PROVEN pseudomonal infections. Levofloxacin have some anti-Gram-positive activity but should not be used as first line treatment
- Individuals at risk of influenza and pneumococcal disease should be followed up for vaccination at convalescence in line with national immunisation guidelines.
Treatment Table - Community Acquired Pneumonia
Assess using the CRB-65 score (each symptom or sign scores one point)
(Confusion, Respiratory rate ≥ 30/min, BP ≤ 90/60, Age ≥ 65)
¥ Stop antibiotic treatment after 5 days unless microbiological results suggest a longer course is needed or the person is not clinically stable
* Alternative doxycycline dose: 100mg every 12 hours.
In non-severe infection, 200mg stat then 100mg every 24 hours can be considered.
Reviewed November 2020