The recommended empirical therapy in adults for the common condition community acquired pneumonia is combination therapy with a narrow spectrum beta lactam antibiotic, to treat typical pathogens, and a macrolide antibiotic or doxycycline, to treat atypical pathogens.
- Community-acquired pneumonia (CAP) is defined as pneumonia occurring in an immunocompetent patient who has not been in hospital for at least 14 days.
- CAP can be difficult to differentiate clinically from many other illnesses, the most common being viral respiratory tract infections. Chest x-ray infiltrate is the feature that best identifies patients as having pneumonia.
- Patients with normal chest x-rays are unlikely to benefit from taking antibiotics.
- Features of CAP that suggest the need for hospitalisation are severe breathlessness, confusion, inability to maintain oral intake, hypotension, hypoxia and multilobar or bilateral changes on chest x-ray.
- Treatment recommendations for CAP are controversial but existing Australian guidelines to use combination antibiotic therapy aimed at typical and atypical pathogens are appropriate.