As in these guidelines, benzylpenicillin or ampicillin remains the mainstay for treatment of community-acquired pneumonia worldwide. In severe pneumonia, use of a suitable aminoglycoside (based on local susceptibilities) is a good approach to provide for empiric Gram negative cover. Avoid use of ceftriaxone or fluoroquinolones for community respiratory tract infection – a key antimicrobial stewardship strategy! An alternative CAP severity scoring system is the SMART-COP system from Australia.
The updated Hunter New England guideline, Adult Community Acquired Pneumonia: Initial Investigation and Empiric Antibiotic Therapy has now been released.
Community acquired pneumonia (CAP) is a common cause of hospital admission, carrying a significant risk of morbidity and mortality. Approximately 1/3 of patients require admission to hospital. Streptococcus pneumoniae remains the commonest pathogen ( see here for local epidemiology).
Studies show that the use of clinical pathways for CAP treatment can reduce mortality, length of stay and ultimately cost. Explicit assessment of severity is important. Severe cases should receive broad spectrum empiric therapy (usually intravenous) as soon as possible.
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