A 81-year-old man is admitted with community-acquired pneumonia. He has a CURB-65 score of 3 (confusion, urea 7, respiratory rate 30). He has a peni...

Question

A 81-year-old man is admitted with community-acquired pneumonia. He has a CURB-65 score of 3 (confusion, urea >7, respiratory rate >30). He has a penicillin allergy (rash only, not anaphylaxis). He has no CKD. According to NICE NG138, what is the MOST appropriate antibiotic regimen?

Accepted Answer

Intravenous antibiotics as per local protocol - typically a beta-lactam (Amoxicillin or Co-amoxiclav IV) plus a macrolide (Clarithromycin), noting that a non-anaphylactic penicillin rash does not preclude penicillin use under specialist guidance

Answer

Amoxicillin 500 mg TDS orally

Answer

Co-amoxiclav 1.2 g IV TDS plus Clarithromycin 500 mg IV BD

Answer

Doxycycline 200 mg stat then 100 mg OD orally

Answer

Ciprofloxacin 400 mg IV BD alone

uk-dgm MCQ (SBA): Severe CAP - Antibiotic Selection

A 81-year-old man is admitted with community-acquired pneumonia. He has a CURB-65 score of 3 (confusion, urea >7, respiratory rate >30). He has a penicillin allergy (rash only, not anaphylaxis). He has no CKD. According to NICE NG138, what is the MOST appropriate antibiotic regimen?