Adult

Community-acquired pneumonia (CAP): non-severe (CURB65= 0-1)

Community-acquired pneumonia (CAP)

  • symptoms consistent with lower respiratory tract infection (i.e. fever, cough, chest pain) AND evidence of consolidation on Chest imaging.

CURB65Confusion (AMT 8 or less), Urea greater than 7, Resp rate 30 or more, BP less than 90 systolic or 60 or less diastolic, Age 65 years or older

  • When respiratory viruses are common, then testing for RSV, influenza and SARSCoV2 indicated
  • HIV AgAb testing is indicated
  • Treatment duration: 3-5 days
  • Review empirical treatment within 48 hours 
  • See also NICE NG138 (revised 2022) and NICE NG191 (revised 2023)

Preferred

amoxicillin  500mg po tds

Alternative

For non-severe and severe penicillin allergy, OR pre-treatment with amoxicillin (within 2 weeks)doxycycline 100 mg po bd 
For penicillin allergy, non-severe and severe AND previously treated with doxycycline within 2 weeks: clarithromycin 500mg bd po 

Alternative in pregnancy for patients with penicillin allergy: erythromycin 500 mg po qds

Consider Delabelling of spurious penicillin allergy in patients who are low risk and are clinically stable. 

Editorial Information

Last reviewed: 27 Sept 2023