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. Author manuscript; available in PMC: 2019 Apr 1.
Published in final edited form as: J Am Geriatr Soc. 2018 Apr;66(4):789–803. doi: 10.1111/jgs.15248

Table 3.

Suggested Empirical Antibiotic Therapy for Nursing Home-Acquired Bacterial Pneumonia.

Clinical Context First-line Second-Line
Mild to moderate pneumonia symptoms

  • cefpodoxime or

  • amoxicillin/clavulanic acid (first choice if aspiration suspected)

  • doxycycline or

  • levofloxacin
Severe pneumonia symptoms or failure to improve with appropriate empirical therapy

  • ceftriaxone and azithromycin

  • ertapenem or

  • levofloxacin
Severe pneumonia symptoms and concern for MRSA in respiratory tract

  • consider adding vancomycin or doxycycline

  • consider adding linezolid
Known history or strong suspicion of Pseudomonas or resistant Gram-negative bacteria in respiratory tract

  • cefepime or

  • piperacillin/tazobactam

  • levofloxacin or

  • carbapenem (other than ertapenam) or

  • aztreonam

MRSA, methicillin-resistant Staphylococcus aureus