Table 3. Empirical initial treatment for in-hospital therapy of community-acquired pneumonia (10).

Severity class	Primary treatment (standard dose)	Alternative treatment (standard dose)
Moderately severe CAP (no acute organ dysfunction)	Beta-lactam IV – Amoxicillin/clavulanic acid (2.2 g q8h) – Ampicillin/sulbactam (3 g q8h) – Cefuroxime (1.5 g q8h) – Ceftriaxone (2 g qd) – Cefotaxime (2 g q8h) + Optional* macrolide IV or po for 3 days – Clarithromycin (500 mg q12h) – Azithromycin (500 mg qd)	Fluoroquinolone IV or po Moxifloxacin (400 mg qd) Levofloxacin (500 mg qd or q12h)
Severe CAP (acute organ dysfunction)	Beta-lactam IV – Piperacillin/tazobactam (4.5 g q6-8h) – Ceftriaxone (2 g qd) – Cefotaxime (2 g q6-8h) + Macrolide IV for 3 days – Clarithromycin (500 mg q12h) – Azithromycin (500 mg qd)	Fluoroquinolone IV Moxifloxacin (400 mg qd) Levofloxacin (500 mg q12h) (no monotherapy in patients with septic shock)

* The additional administration of a macrolide is optional because prospective, placebo-controlled trials have not clearly shown that they improve the outcome