Antibiotic Guide for Community Acquired Aspiration Pneumonia

Co-amoxiclav IV 1.2g tds

or If rash with penicillins: Cefuroxime IV 1.5g tds plus Metronidazole IV 500mg tds

plus

If high risk of MRSA: Gentamicin 5 mg/kg stat IV over 20-30 mins , as a single dose with microbiological review prior to further doses, (to a maximum 500mg - reduce dose in renal impairment)

plus

If possible atypical pathogen Clarithromycin IV 500mg bd

If severe allergy to Penicillins or cephalosporin allergy discuss with microbiology

Notes

• Review the need for IV antibiotics on the post-take ward round and daily thereafter. Patients initially treated with IV antibiotics should be transferred to oral therapy as soon as clinical improvement occurs and the temperature has been normal for 24 hours.
• Antibiotic treatment should be given for 10 days in total unless legionella, staphylococcal or Gram negative pneumonia suspected or confirmed, in which case, treat for 14 - 21 days.

The Full Guideline "Nottingham Hospitals Antibiotic Guidelines for Adult Patients With Community Acquired Pneumonia" is available here.

Page last edited: 03/04/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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