Table 3. Recommended Antimicrobials for Outpatient Treatment of CAP (continued)
Antimicrobial Cephalosporins
Ceftriaxone (Rocephin®
)
Cefpodoxime proxetil (Vantin®
)
Cefprozil (Cefzil ®
)
Cefuroxime axetil (Ceftin®
)
Cefditoren pivoxil (Spectracef ®
)
Cefdinir (Omnicef®
) PO ) Fluoroquinolones
Moxifloxacin (Avelox®
Gemifloxacin (Factive®
)
Levofloxacin (Levaquin®
) Macrolides
Azithromycin (Zithromax®
)
Clarithromycin (Biaxin®
) (Biaxin XL® Penicillins
Amoxicillin (Amoxil ®
, others) PO 1 g tid †
> Dose listed is specified for empirical therapy based on presence of risk factors for resistance, lower doses are adequate for penicillin- susceptible S. pneumoniae; lacks activity against atypical pathogens and β-lactamase producers
5 )
Erythromycin (Ery-tab®
, others) PO 500 mg qd 1st day, then
250 mg qd × 4 OR 2 g extended release x 1 dose
PO PO
PO
500 mg q12h 2 x 500 mg q24h
500 mg q6-8h
> Macrolides active against most common pathogens including atypical pathogens
> Erythromycin poorly tolerated and less effective against H. influenzae
IV, PO 750 mg qd †‡ IV, PO PO 400 mg qd 320 mg qd
> Active against S. pneumoniae (including penicillin- resistant strains), H. influenzae, methicillin- susceptible S. aureus, and atypical pathogens
300 mg q12h PO 400 mg bid PO 500 mg q12h † PO 500 mg q12h Route
IV, IM
PO Adult Dose* 1 g q24h 200 mg q12h Comments
> Ceftriaxone is an alternative to high-dose amoxicillin when parenteral therapy is feasible
> Oral cephalosporins active against most S. pneumoniae and nearly all H. influenzae
> All cephalosporins inactive against atypical pathogens
