Pathogen Directed Therapy - CAP

Question 1

Streptococcus pneumoniae (MIC < 2)

Answer 1

Preferred = Penicillin G; amoxicillin

Alternative = Macrolide; cephalosporin; respiratory FQ; doxycycline

Question 2

Streptococcus pneumoniae (MIC >/= 2)

Answer 2

Preferred = Respiratory FQ; ceftriaxone, cefotaxime

Alternative = Vancomycin; linezolid; high-dose amoxicillin (3g/day)

Question 3

Haemophilus influenzae (Non-beta-lactamase producing)

Answer 3

Preferred = Amoxicillin

Alternative = FQ; doxycycline; azithromycin; clarithromycin

Question 4

Haemophilus influenzae (Beta-lactamase producing)

Answer 4

Preferred = 2nd or 3rd generation cephalosporin; Augmentin

Alternative = Q; doxycycline; azithromycin; clarithromycin

Question 5

Mycoplasma pneumoniae

Answer 5

Preferred = Macrolide; doxycycline

Alternative = FQ

Question 6

Chlamydophila pneumoniae

Answer 6

Preferred = Macrolide; doxycycline

Alternative = FQ

Question 7

Legionella pneumophila

Answer 7

Preferred = FQ; azithromycin

Alternative = doxycycline

Question 8

Staphylococcus aureus (MSSA)

Answer 8

Preferred = Nafcillin; oxacillin

Alternative = Cefazolin; clindamycin

Question 9

Staphylococcus aureus (MRSA)

Answer 9

Preferred = Vancomycin; linezolid

Alternative = Bactrim

Question 10

Anaerobes (aspiration)

Answer 10

Preferred = beta-lactam/beta-lactamase inhibitor; clindamycin

Alternative = Carbapenem

Question 11

Enterobacteriaceae

Answer 11

Preferred = 3rd or 4th generation cephalosporin; carbapenem

Alternative = beta-lactam/beta-lactamase inhibitor; FQ