Patient group | ATS/IDSA outpatient CAP empiric antibiotic recommendations | UpToDate CAP outpatient empiric antibiotic recommendations |
Adult outpatients aged <65 years, without comorbidities or smoking, and who have not used antibiotics within the prior three months | The ATS/IDSA recommends amoxicillin monotherapy. For those who cannot use penicillins, monotherapy with either a macrolide or doxycycline is recommended, provided local resistance rates among S. pneumoniae isolates are <25%.* | UpToDate suggests amoxicillin plus a macrolide or doxycycline as preferred therapy because there is a potential morbidity benefit and the downside of a short course of therapy for most patients is low. |
Adult outpatients who meet any of the following criteria:
| ATS/IDSA recommends either:
There is no stated preference between these regimens. | UpToDate suggests combination therapy with amoxicillin-clavulanate plus a macrolide or doxycycline. Amoxicillin-clavulanate has reliable activity against S. pneumoniae and an overall favorable adverse effect profile. |
CAP: community-acquired pneumonia; ATS/IDSA: American Thoracic Society/Infectious Diseases Society of America; S. pneumoniae: Streptococcus pneumoniae.
* For macrolides, resistance rates among S. pneumoniae are often >30% in the United States and typically >25% for most parts of the world, apart from some regions in Northern Europe. For doxycycline, resistance rates are less well established but are approximately 10 to 20% in the United States and likely rising.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟