Hospital-associated LRTI/Pneumonia (recent hospital admission with ≥5 days stay in previous 4 weeks)

Antimicrobial prescribing: NHS Forth Valley
NHS Forth Valley

First Line

Therapy

Doxycyline 100mg PO 12 hourly

Notes:

If oral route compromised:

Ceftriaxone 2g IV 24 hourly

Second Line

Therapy

Co-trimoxazole 960mg PO 12 hourly

(see BNF for dosing advice of co-trimoxazole in patients with renal impairment [<30 ml/min])

 

If oral route compromised:

Ceftriaxone 2g IV 24 hourly (administered as per local SOP) 

Notes:

Severe Infection

Therapy

Ceftriaxone 2g IV 24 hourly (administer as per local SOP)

or

Levofloxacin 500mg PO/IV 12 hourly (consider safety issues and dose adjustment if CrCl <50)

Notes:

Notes

NB -BTS Definition of Pneumonia

Cough and at least one other lower respiratory tract symptom AND new focal chest signs on examination AND EITHER sweating, fevers, shivers, aches and pains OR fever > 38°C AND no other explanation for symptoms

Send sputum for culture if possible and appropriate. Culture most useful where there has been poor clinical response to an empirical antibiotic previously or where antibiotic options are limited e.g. allergy, drug interaction.

Check HEPMA to review recent antibiotic courses that may influence antibiotic choice