Treatment for Community-Acquired Pneumonia

Treatment Algorithm Based on Setting

The British Thoracic Society recommends oral amoxicillin at a higher dose than previously used for outpatients, or combination therapy with amoxicillin plus a macrolide for hospitalized patients with community-acquired pneumonia found on chest X-ray 1, 2
For outpatient treatment, the first-line therapy is high-dose amoxicillin, according to the British Thoracic Society 1, 3
For patients with non-severe community-acquired pneumonia requiring hospitalization, the preferred regimen is combined oral therapy with amoxicillin plus a macrolide, as recommended by the British Thoracic Society 1, 4
The British Thoracic Society suggests that most hospitalized patients can be adequately treated with oral antibiotics 4

The British Thoracic Society recommends oxygen therapy with monitoring of oxygen saturations for all hospitalized patients 3
Patients should be assessed for volume depletion and may require intravenous fluids, according to the British Thoracic Society 2, 6
The British Thoracic Society recommends pain management using simple analgesia such as paracetamol for pleuritic pain 3
Nutritional support should be given in prolonged illness, as recommended by the British Thoracic Society 2, 3

The British Thoracic Society recommends monitoring vital signs, including temperature, respiratory rate, pulse, blood pressure, mental status, and oxygen saturation, at least twice daily initially 2, 6
The British Thoracic Society suggests that laboratory follow-up, including CRP level, should be remeasured in patients not progressing satisfactorily 2, 3
The Infectious Diseases Society of America recommends considering repeat chest radiograph and further investigations in patients who are not progressing satisfactorily 2, 6

The British Thoracic Society recommends clinical review at around 6 weeks, either with their general practitioner or in a hospital clinic 1
A chest radiograph should be arranged at 6 weeks for patients with persistent symptoms or physical signs, or those at higher risk of underlying malignancy, as recommended by the British Thoracic Society 1