Respiratory tract infections
Respiratory tract infections
Clinical condition | Common pathogens | Empirical antimicrobial agents | Alternative antimicrobial agents | Comments |
---|---|---|---|---|
Pneumonia | S. pneumoniae, H. influenzae, Legionella spp, K. pneumoniae, P. aeruginosa, Acinetobacter spp | Piperacillin-tazobactam plus azithromycin or doxycycline Duration 5-7 days |
Imipenem-cilastatin | If MRSA is a concern, add linezolid. Avoid fluoroquinolones unless TB excluded. Consider TB, influenza, Nocardia, fungi. |
Pneumocystis jirovecii | Co-trimoxazole | Clindamycin plus primaquine (if sulpha allergy) |
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Lung abscess, empyema | S. pneumoniae, viridans streptococci, K. pneumoniae, P. aeruginosa, S. aureus |
Piperacillin-tazobactam | Cefoperazone-sulbactam + clindamycin | Drainage of pleural space essential for empyema. Duration: 3-4 weeks |
Acute bacterial pharyngitis | Streptococcus pyogenes | Benzathine penicillin or amoxycillin | Most cases viral. Confirm bacterial etiology before antibiotic Rx | |
Head & neck space infections | Polymicrobial, S. pyogenes, S. aureus, viridans streptococci, oral anaerobes |
Clindamycin or amoxy-clav | Piperacillin-tazobactam | |
Acute sinusitis | Viral, S. pneumoniae, H. influenzae, M. catarrhalis |
Amoxy-clav | Piperacillin-tazobactam | Exclude fungal etiology |
Acute bronchitis | Mostly viral | Antibiotics not needed |