علاج الالتهاب الرئوي بالمكورات العنقودية الذهبية في البالغين الأصحاء المصابين بالتهاب رئة مكتسب من المجتمع (مرضى خارجيون)

References

DOI: 10.1164/rccm.201908-1581ST

• For healthy outpatient adults without comorbidities listed below or risk factors for antibiotic resistant pathogens, we recommend (Table 3):
• amoxicillin 1 g three times daily (strong recommendation, moderate quality of evidence), or
• doxycycline 100 mg twice daily (conditional recommendation, low quality of evidence), or
• a macrolide (azithromycin 500 mg on first day then 250 mg daily or clarithromycin 500 mg twice daily or clarithromycin extended release 1,000 mg daily) only in areas with pneumococcal resistance to macrolides <25% (conditional recommendation, moderate quality of evidence).
• antibiotic therapy should be continued until the patient achieves stability and for no less than a total of 5 days (strong recommendation, moderate quality of evidence).
• We recommend that the duration of antibiotic therapy should be guided by a validated measure of clinical stability (resolution of vital sign abnormalities [heart rate, respiratory rate, blood pressure, oxygen saturation, and temperature], ability to eat, and normal mentation), and antibiotic therapy should be continued until the patient achieves stability and for no less than a total of 5 days (strong recommendation, moderate quality of evidence).
• As most patients will achieve clinical stability within the first 48 to 72 hours, a total duration of therapy of 5 days will be appropriate for most patients.