Community Acquired Pneumonia - Treatment in the Community

Start antibiotics immediately.

Use CRB65 score to assess severity.

Each CRB65 parameter scores 1: 

Confusion (AMT8); Respiratory rate ≥30/min; BP systolic <90 or diastolic ≤60; Age 65; 

If no response in 48 hours consider admission.

If CRB 65 = 1 or 2 consider need for hospital admission. If at home, clinically assess need for dual therapy for atypicals.

 

If CRB65=0 

Amoxicillin

 

500mg 3 x daily

child dose

 

 

5 days

Alternative treatment

If CRB65=0 

Doxycycline 

(not suitable for those under 12 years)

 

 

200mg on Day 1

then 100mg daily

 

 

5 days

OR

If CRB65 = 0

Clarithromycin 

 

 

500mg 2 x daily

child dose

 

 

5 days

If CRB65=1 or 2 & AT HOME - clinically assess need for dual therapy for atypicals:

Amoxicillin

 

 

 500mg 3 x daily

child dose

 

 

 5 days

AND (if dual therapy for atypicals required)

Clarithromycin 

 

500mg 2 x daily

child dose

 

5 days

Alternative treatment

If CRB65=1 or 2 & AT HOME 

Doxycycline alone

(not suitable for those under 12 years)

 

 

200mg on Day 1

then 100mg once daily

 

 

5 days