During COVID-19 pandemic, please see separate antibiotic management document

Note: Avoid tetracyclines in pregnancy. Low doses of penicillins are more likely to select out resistance, we recommend 500mg of amoxicillin. Do not use quinolone (ciprofloxacin, ofloxacin) first line due to poor pneumococcal activity. Reserve all quinolones (including levofloxacin) for proven resistant organisms.

Local resistance information for NHS Highland indicates low levels of penicillin and tetracycline resistance to Streptococcus pneumoniae, the major pathogen in community-acquired pneumonia. Tetracycline resistance is also low in Haemophilus influenzae, a common respiratory pathogen in COPD exacerbations.