Adult
Healthcare-associated pneumonia (HAP) including aspiration pneumonia
Healthcare-associated pneumonia: non severe (including aspiration pneumonia)
Healthcare-associated pneumonia: non severe (including aspiration pneumonia)
For frail patients: Refer to LRTI + functional decline
- Healthcare: Hospital, community hospital, nursing home.
- Aspiration pneumonia does NOT require antimicrobial treatment unless there is clear evidence of secondary bacterial infection.
- Patients who have tracheostomy or are intubated can have respiratory sampling performed.
- Legionella antigen testing on urine can be considered.
- SARSCoV2 Resp PCR indicated
- When community respiratory viruses are common RSV and/or influenza testing is indicated
- Modify treatment according to sensitivity test results.
- See also NICE NG139 (revised 2019)
Treat for 3-5 days
Review empirical treatment within 48 hours
Preferred:
- amoxicillin 500mg tds po
Alternative:
For penicillin allergy, mild or severe
- doxycycline 100mg po bd
Healthcare-associated pneumonia: severe (including aspiration pneumonia)
- Healthcare: Hospital, community hospital, nursing home.
- For more complex cases where escalation of treatment is considered, please discuss with Micro ID.
- Patients who have tracheostomy or are intubated can have respiratory sampling performed.
- Legionella antigen testing on urine can be considered.
- Modify treatment according to sensitivity test results.
Treat for 3-5 days (review iv daily)
Preferred:
- co-amoxiclav 1.2g iv tds (or 625mg po tds)
Alternative:
Penicillin allergy (non-severe and severe) or MRSA positive patients:
- co-trimoxazole 960mg bd po or iv
Consider Delabelling of spurious penicillin allergy in patients who are low risk and are clinically stable.