A 35 year-old male is being seen in the ER with a chief complaint of severe righ

Question

A 35 year-old male is being seen in the ER with a chief complaint of severe right-sided chest pain. Two hours prior to admission, he felt feverish and experienced a "teeth-chattering" chill. Shortly after this episode, his chest began hurting; the pain has increased in intensity over the 30 minutes to the point where it is now quite difficult to breathe. He has a productive cough and his sputum has a rust colored appearance. His respiration is shallow and rapid. He has no significant past medical history and has NKDA. He is admitted to the general medicine floor for treatment of CAP. Which empiric antibiotic regimen would you recommend?

Ceftriaxone [Rocephin] 1 g IV daily PLUS levofloxacin [Levaquin] 500 mg IV daily

Azithromycin [Zithromax] 500 mg IV daily

Vancomycin 1000 mg IV every 12 hours PLUS ceftriaxone [Rocephin] 1 gram every 8 hours

Levofloxacin [Levaquin] 500 mg IV daily

The Gram stain of the above patient showed many white blood cells and many Gram-positive diplococci in chains. Culture of the specimen grew out S. pneumoniae sensitive to amoxicillin, penicillin, levofloxacin and vancomycin. When the patient has satisfied the criteria to switch to the oral route for completion of therapy, which of the following oral antibiotic regimens would be MOST PREFERRED in efforts to BEST STREAMLINE or NARROW therapy?

Azithromycin [Zithromax] 500 mg PO daily

Amoxicillin/Clavulanate [Augmentin] 875 mg po BID

Cephalexin 500 mg PO QID plus azithromycin [Zithromax] 500 mg PO daily

Levofloxacin [Levaquin] 500 mg PO daily

Explanation / Answer

Since S. pneumonia sensitive to amoxicillin, pencillin, levofloxacin and vancomycin, the drug of choice for oral route for completion of therapy is: Azithromycin (Zithromax) 500 mg PO daily to treat the condition.

Azithromycin for Pneumonia:

Oral:

Uses:

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