What is the role of empiric therapy in the treatment of community-acquired pneumonia?

Updated: Jul 22, 2021
  • Author: Folusakin O Ayoade, MD; Chief Editor: Thomas E Herchline, MD  more...
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For all suspected CAP patients with the exception of COVID-19, in light of better outcomes with the earliest possible interventions, the Infectious Diseases Society of America (IDSA) recommends initial empiric antimicrobial therapy until laboratory results can be obtained to guide more specific therapy. [4]

Empiric therapeutic regimens for CAP are outlined below, including those for outpatients with or without comorbidities, intensive care unit (ICU) and non-ICU patients, and penicillin-allergic patients. [4]

In this setting, empiric regimens are designed to target S pneumoniae, the most common, and atypical, pathogens. Coverage is expanded for outpatients with comorbidities, smoking, and recent antibiotic use to include or better treat beta-lactamase-producing H influenzaeM catarrhalis, and methicillin-susceptible S aureus. For those with structural lung disease, such as cystic fibrosis, coverage is further expanded to include Enterobacteriaceae, such as E coli and Klebsiella spp.

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