Table.

Empirical antibiotics suggested for community-acquired pneumonia

	American (IDSA/ATS)3		British (NICE/BTS)4, 6		European5
	Preferred	Alternative	Preferred	Alternative	Preferred	Alternative
Outpatient without comorbidities; low severity	Macrolide	Doxycycline	Amoxicillin	Macrolide or tetracycline	Amoxicillin or tetracycline	Macrolide
Outpatient with comorbidities or high rate bacterial resistance	β-lactam plus macrolide	Respiratory fluoroquinolone			Respiratory fluoroquinolone
Inpatient not in ICU; moderate severity	β-lactam* plus macrolide	Respiratory fluoroquinolone	Amoxicillin plus macrolide	Respiratory fluoroquinolone†	Aminopenicillin with or without macrolide	Respiratory fluoroquinolone
Inpatient in ICU; high severity	β-lactam‡ plus macrolide	β-lactam‡ plus respiratory fluoroquinolone	β-lactamase stable β-lactams¶ plus macrolide	Respiratory fluoroquinolone†	Third-generation cephalosporin§ plus macrolide	Respiratory fluoroquinolone with or without a third-generation cephalosporin§

Local or adapted guidelines should be used to adapt for different epidemiology. IDS=Infectious Diseases Society of America. ATS=American Thoracic Society. NICE=National Institute for Health and Care Excellence. BTS=British Thoracic Society. ICU=intensive care unit.

^*Preferred β-lactam drugs include cefotaxime, ceftriaxone, and ampicillin.

^†Respiratory fluoroquinolone limited to situations in which other options cannot be prescribed or are ineffective (eg, hepatotoxicity, skin reactions, cardiac arrhythmias, and tendon rupture).

^‡Preferred β-lactam drugs include cefotaxime, ceftriaxone, or ampicillin-sulbactam.

^¶β-lactamase-stable β-lactams include co-amoxiclav, cefotaxime, ceftaroline fosamil, ceftriaxone, cefuroxime, and piperacillin-tazobactam.

^§Third-generation cephalosporin (eg, cefotaxime, ceftriaxone).