Today we discussed short course treatments for CAP. In the last decade there have been trials looking and five day treatments with
levofloxacin in adults and even five day treatments of severe pneumonia with high dose
amoxicillin in kids. Azithromycin is usually used for short courses (3-5 days) for CAP, mainly because of its unique long half-life, different from almost all other antibiotics. A special formulation of azithromycin has even been used to treat CAP with a
single 2g dose!!
Remember to always consider severity of CAP, using either the
PSI/PORT score or the
CURB 65 score. These are useful for prognosis and to decide on inpatient vs outpatient treatment.
Overall, there is still a lack of evidence for all approaches to treating CAP. Check out this
recent review for more discussion of the issues of: lenghth of therapy, use of procalcitonin and choice of abx.
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