Community Acquired Pneumonia Treatment in the Community (Adults)

Doses are oral and for adults unless otherwise stated. Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC). See guidance on dosing in children for quick reference dosage/weight guide. Refer to drug interactions table for detailed drug interactions for all antimicrobials. Note extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.

Note additional warnings for clarithromycin and fluoroquinolones

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

CRBsept 122018pneumoniaadultsOct1

Treatment table for Community Acquired Pneumonia Treatment in the Community (Adults) PDF

See guidance on dosing in children for quick reference dosage/weight guide.

Patient Information

Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)

We recommend patients use the website developed by HSE/ICGP/IPU partnership for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

Reviewed Dec 2019