Table 3.

Initial Treatment Strategies for Outpatients with Community-acquired Pneumonia

	Standard Regimen
No comorbidities or risk factors for MRSA or Pseudomonas aeruginosa*	Amoxicillin or
	doxycycline or
	macrolide (if local pneumococcal resistance is <25%)†
With comorbidities‡	Combination therapy with
	amoxicillin/clavulanate or cephalosporin
	AND
	macrolide or doxycycline§
	OR
	monotherapy with respiratory fluoroquinolone||

Definition of abbreviations: ER = extended release; MRSA = methicillin-resistant Staphylococcus aureus.

^*Risk factors include prior respiratory isolation of MRSA or P. aeruginosa or recent hospitalization AND receipt of parenteral antibiotics (in the last 90 d).

^†Amoxicillin 1 g three times daily, doxycycline 100 mg twice daily, azithromycin 500 mg on first day then 250 mg daily, clarithromycin 500 mg twice daily, or clarithromycin ER 1,000 mg daily.

^‡Comorbidities include chronic heart, lung, liver, or renal disease; diabetes mellitus; alcoholism; malignancy; or asplenia.

^§Amoxicillin/clavulanate 500 mg/125 mg three times daily, amoxicillin/clavulanate 875 mg/125 mg twice daily, 2,000 mg/125 mg twice daily, cefpodoxime 200 mg twice daily, or cefuroxime 500 mg twice daily; AND azithromycin 500 mg on first day then 250 mg daily, clarithromycin 500 mg twice daily, clarithromycin ER 1,000 mg daily, or doxycycline 100 mg twice daily.

^||Levofloxacin 750 mg daily, moxifloxacin 400 mg daily, or gemifloxacin 320 mg daily.