Template:Pneumonia Antibiotics - Revision history

Danbot: Fix disease parameter: Pneumonia (main) instead of Aspiration pneumonia and pneumonitis

2026-03-19T23:13:27Z

Fix disease parameter: Pneumonia (main) instead of Aspiration pneumonia and pneumonitis

Danbot: Add disease=Aspiration pneumonia and pneumonitis parameter to AntibioticDose calls - fixes aggregation page display issue

2026-03-19T23:12:39Z

Add disease=Aspiration pneumonia and pneumonitis parameter to AntibioticDose calls - fixes aggregation page display issue

Show changes

Danbot: Rewrote to use {{AntibioticDose}} template - single source of truth for drug dosing (display + SMW annotation from one place). Removed old separate #subobject annotations.

2026-03-19T19:50:16Z

Rewrote to use {{AntibioticDose}} template - single source of truth for drug dosing (display + SMW annotation from one place). Removed old separate #subobject annotations.

Show changes

Danbot: Added SMW #subobject annotations for all antibiotics with dosing and clinical context. These create semantic data linking antibiotics to pneumonia when template is transcluded.

2026-03-19T19:27:31Z

Added SMW #subobject annotations for all antibiotics with dosing and clinical context. These create semantic data linking antibiotics to pneumonia when template is transcluded.

Show changes

Ostermayer at 16:10, 8 March 2026

2026-03-08T16:10:08Z

Show changes

Krca242: /* Hospital Acquired or Ventilator Associated Pneumonia */

2020-06-26T01:20:01Z

Hospital Acquired or Ventilator Associated Pneumonia

← Older revision		Revision as of 01:20, 26 June 2020
Line 49:		Line 49:
	**[[Piperacillin-Tazobactam]] 4.5gm q6h + [[cipro]] 400mg q8h + [[vanco]] 15mg/kg q12		**[[Piperacillin-Tazobactam]] 4.5gm q6h + [[cipro]] 400mg q8h + [[vanco]] 15mg/kg q12
	*Consider [[tobramycin]] in place of fluoroquinolones given FDA 2016 warnings		*Consider [[tobramycin]] in place of fluoroquinolones given FDA 2016 warnings
			*Of note, the combination of [[vanco]]+ [[piperacillin-tazobactam]] carries higher risk of [[AKI]] when compared to [[cefepime ]]+ [[vanco]]’’’<ref> Luther MK, Timbrook TT, Caffrey AR, Dosa D, Lodise TP, LaPlante KL. Vancomycin Plus Piperacillin-Tazobactam and Acute Kidney Injury in Adults: A Systematic Review and Meta-Analysis. Crit Care Med. 2018;46(1):12-20.</ref>

	====Ventilator Associated Pneumnoia====		====Ventilator Associated Pneumnoia====

Rossdonaldson1: /* Unhealthy Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67 */

2019-11-28T22:27:26Z

Unhealthy Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67

← Older revision		Revision as of 22:27, 28 November 2019
Line 15:		Line 15:
	*Combination therapy:		*Combination therapy:
	**[[Amoxicillin/Clavulanate]]		**[[Amoxicillin/Clavulanate]]
	***500 mg/125 mg TID OR amox/clav 875 mg/125 mg BID OR 2,000 mg/125 mg BID. Duration is for a minimum of 5 days and varies based on disease severity and response to therapy; patients should be afebrile for ≥48 hours and clinically stable before therapy is discontinued (IDSA [Mandell 2007])		***500 mg/125 mg TID OR amox/clav 875 mg/125 mg BID OR 2,000 mg/125 mg BID. Duration is for a minimum of 5 days and varies based on disease severity and response to therapy; patients should be afebrile for ≥48 hours and clinically stable before therapy is discontinued<ref>IDSA. Mandell 2007</ref>
	**OR [[cephalosporin]]		**OR [[cephalosporin]]
	***[[Cefpodoxime]] 200 mg BID OR [[cefuroxime]] 500 mg BID		***[[Cefpodoxime]] 200 mg BID OR [[cefuroxime]] 500 mg BID

Bouspret: /* Unhealthy Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67 */

2019-11-13T21:45:25Z

← Older revision		Revision as of 21:45, 13 November 2019
Line 15:		Line 15:
	*Combination therapy:		*Combination therapy:
	**[[Amoxicillin/Clavulanate]]		**[[Amoxicillin/Clavulanate]]
	***500 mg/125 mg TID OR amox/clav 875 mg/125 mg BID OR 2,000 mg/125 mg BID		***500 mg/125 mg TID OR amox/clav 875 mg/125 mg BID OR 2,000 mg/125 mg BID. Duration is for a minimum of 5 days and varies based on disease severity and response to therapy; patients should be afebrile for ≥48 hours and clinically stable before therapy is discontinued (IDSA [Mandell 2007])
	**OR [[cephalosporin]]		**OR [[cephalosporin]]
	***[[Cefpodoxime]] 200 mg BID OR [[cefuroxime]] 500 mg BID		***[[Cefpodoxime]] 200 mg BID OR [[cefuroxime]] 500 mg BID
Line 25:		Line 25:
	**[[Levofloxacin]] 750 mg daily OR		**[[Levofloxacin]] 750 mg daily OR
	**[[Moxifloxacin]] 400 mg daily OR		**[[Moxifloxacin]] 400 mg daily OR
	**[[Gemifloxacin]] 320 mg daily		**[[Gemifloxacin]] 320 mg daily

	===Inpatient===		===Inpatient===

ClaireLewis at 14:23, 23 October 2019

2019-10-23T14:23:35Z

← Older revision		Revision as of 14:23, 23 October 2019
Line 1:		Line 1:
	===Outpatient===		===Outpatient===
	''Coverage targeted at [[S. pneumoniae]], [[H. influenzae]]. [[M. pneumoniae]], [[C. pneumoniae]], and [[Legionella]]		''Coverage targeted at [[S. pneumoniae]], [[H. influenzae]]. [[M. pneumoniae]], [[C. pneumoniae]], and [[Legionella]]
	====Healthy~~====~~		====Healthy<ref> Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America [https://www.atsjournals.org/doi/full/10.1164/rccm.201908-1581ST Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67] </ref>====
	~~From IDSA 2019 guidelines~~ <ref> Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America [https://www.atsjournals.org/doi/full/10.1164/rccm.201908-1581ST Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67] </ref>		''No comorbidities (chronic heart, lung, liver, or renal disease; diabetes mellitus; alcoholism; malignancy; or asplenia) and no or risk factors for [[MRSA]] or [[Pseudomonas aeruginosa]] (include prior respiratory isolation of MRSA or P. aeruginosa or recent hospitalization AND receipt of parenteral antibiotics (in the last 90 d))''

	~~If no comorbidities~~ (~~chronic heart~~, ~~lung~~, ~~liver~~, ~~or renal disease; diabetes mellitus; alcoholism; malignancy; or asplenia~~) ~~and no or risk factors for MRSA or Pseudomonas aeruginosa~~ (~~include prior respiratory isolation~~ of ~~MRSA or P~~. ~~aeruginosa~~ or ~~recent hospitalization AND receipt~~ of ~~parenteral antibiotics (in the last 90 d)).~~		*[[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
			*[[Macrolide]] in areas with pneumococcal resistance to macrolides <25% (conditional recommendation, moderate quality of evidence).
			**[[Azithromycin]] 500 mg on first day then 250 mg daily OR
			**[[Clarithromycin]] 500 mg BID or clarithromycin ER 1,000 mg daily
			*Duration of therapy 5 days minimum

	~~Duration of therapy minimal of 5 days.~~		==== Unhealthy<ref> Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America [https://www.atsjournals.org/doi/full/10.1164/rccm.201908-1581ST Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67] </ref>====
			''If patient has comorbidities or risk factors for MRSA or Pseudomonas aeruginosa''
	*amoxicillin 1 g three times daily (strong recommendation, moderate quality of evidence), or		*Combination therapy:
	*doxycycline 100 mg twice daily (conditional recommendation, low quality of evidence), or		**[[Amoxicillin/Clavulanate]]
	*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).		***500 mg/125 mg TID OR amox/clav 875 mg/125 mg BID OR 2,000 mg/125 mg BID
			**OR [[cephalosporin]]
	==== Unhealthy ~~====~~		***[[Cefpodoxime]] 200 mg BID OR [[cefuroxime]] 500 mg BID
	~~Per IDSA 2019~~ <ref> Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America [https://www.atsjournals.org/doi/full/10.1164/rccm.201908-1581ST Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67] </ref> ~~if have~~ comorbidities or risk factors for MRSA or Pseudomonas aeruginosa:		**AND [[macrolide]]
			***[[Azithromycin]] 500 mg on first day then 250 mg daily
	Combination therapy:		***OR [[clarithromycin]] 500 mg BID OR clarithromycin ER 1,000 mg daily]) (strong recommendation, moderate quality of evidence for combination therapy)
	*~~amoxicillin~~/~~clavulanate~~ 500 mg/125 mg ~~three times daily, or amoxicillin~~/~~clavulanate~~ 875 mg/125 mg ~~twice daily, or~~ 2,000 mg/125 mg ~~twice daily, or a~~ cephalosporin ~~(cefpodoxime~~ 200 mg ~~twice daily or~~ cefuroxime 500 mg ~~twice daily);~~ AND		**OR [[doxycycline]] 100 mg BID (conditional recommendation, low quality of evidence for combination therapy)
			*Monotherapy: respiratory [[fluoroquinolone]] (strong recommendation, moderate quality of evidence):
	*~~macrolide (azithromycin~~ 500 mg on first day then 250 mg daily, clarithromycin [500 mg ~~twice daily or extended release~~ 1,000 mg ~~once~~ daily]) (strong recommendation, moderate quality of evidence for combination therapy)~~, or~~ doxycycline 100 mg ~~twice daily~~ (conditional recommendation, low quality of evidence for combination therapy)~~; OR~~		**[[Levofloxacin]] 750 mg daily OR
			**[[Moxifloxacin]] 400 mg daily OR
	Monotherapy:		**[[Gemifloxacin]] 320 mg daily
	*respiratory fluoroquinolone (~~levofloxacin~~ 750 mg daily~~, moxifloxacin~~ 400 mg daily~~, or gemifloxacin~~ 320 mg daily~~) (strong recommendation, moderate quality of evidence).~~

	===Inpatient===		===Inpatient===
	*Monotherapy or combination therapy is acceptable. Combination therapy includes a cephalosporin and macrolide targeting atypicals and Strep Pneumonia <ref>Chokshi R, Restrepo MI, Weeratunge N, Frei CR, Anzueto A, Mortensen EM. Monotherapy versus combination antibiotic therapy for patients with bacteremic Streptococcus pneumoniae community-acquired pneumonia. Eur J Clin Microbiol Infect Dis. Jul 2007;26(7):447-51</ref>		*Monotherapy or combination therapy is acceptable
			*Combination therapy includes a [[cephalosporin]] and [[macrolide]] targeting atypicals and Strep Pneumonia <ref>Chokshi R, Restrepo MI, Weeratunge N, Frei CR, Anzueto A, Mortensen EM. Monotherapy versus combination antibiotic therapy for patients with bacteremic Streptococcus pneumoniae community-acquired pneumonia. Eur J Clin Microbiol Infect Dis. Jul 2007;26(7):447-51</ref>
	*The use of adjunctive corticosteroids ([[methylprednisolone]] 0.5 mg/kg IV BID x 5d) in CAP of moderate-high severity (PSI Score IV or V; [[CURB-65]] ≥ 2) is associated with:<ref>Siemieniuk RA, Meade MO, Alonso-Coello P, Briel M, Evaniew N, Prasad M, Alexander PE, Fei Y, Vandvik PO, Loeb M, Guyatt GH. Corticosteroid Therapy for Patients Hospitalized With Community-Acquired Pneumonia: A Systematic Review and Meta-analysis. Ann Intern Med. Aug 11, 2015</ref>		*The use of adjunctive corticosteroids ([[methylprednisolone]] 0.5 mg/kg IV BID x 5d) in CAP of moderate-high severity (PSI Score IV or V; [[CURB-65]] ≥ 2) is associated with:<ref>Siemieniuk RA, Meade MO, Alonso-Coello P, Briel M, Evaniew N, Prasad M, Alexander PE, Fei Y, Vandvik PO, Loeb M, Guyatt GH. Corticosteroid Therapy for Patients Hospitalized With Community-Acquired Pneumonia: A Systematic Review and Meta-analysis. Ann Intern Med. Aug 11, 2015</ref>
	**↓ mortality (3%)		**↓ mortality (3%)
Line 32:		Line 37:
	====Community Acquired (Non-ICU)====		====Community Acquired (Non-ICU)====
	''Coverage against community acquired organisms plus [[M. catarrhalis]], [[Klebsiella]], [[S. aureus]]		''Coverage against community acquired organisms plus [[M. catarrhalis]], [[Klebsiella]], [[S. aureus]]
			*[[β-lactam]] (e.g. [[ceftriaxone]] 1–2g daily OR [[ampicillin-sulbactam]] 1.5–3g q6h OR [[cefotaxime]] 1–2g q8h OR [[ceftaroline]] 600mg q12h) '''PLUS'''
	*β-lactam (~~ampicillin + sulbactam 1~~.~~5–3~~ g ~~every 6 h, cefotaxime 1–2 g every 8 h,~~ ceftriaxone ~~1–2 g~~ daily~~, or~~ ceftaroline ~~600 mg every 12 h~~) '''PLUS'''		**[[Macrolide]] (e.g. [[azithromycin]] 500 mg daily or [[clarithromycin]] 500 mg BID)'''OR'''
	**~~a macrolide~~ (azithromycin 500 mg daily or clarithromycin 500 mg ~~twice daily~~)'''OR'''
	**[[Doxycycline]] 100mg IV/PO BID (if contraindications to both macrolides and fluoroquinolones ) '''OR'''		**[[Doxycycline]] 100mg IV/PO BID (if contraindications to both macrolides and fluoroquinolones ) '''OR'''

	*[[Levofloxacin]] 750mg IV/PO once daily '''OR'''		*[[Levofloxacin]] 750mg IV/PO once daily '''OR'''
	*[[Moxifloxacin]] 400mg IV/PO once daily		*[[Moxifloxacin]] 400mg IV/PO once daily
Line 60:		Line 63:

	====ICU, risk of pseudomonas====		====ICU, risk of pseudomonas====
	* [[~~Cefipime~~]], [[Imipenem]], '''OR''' [[Piperacillin/Tazobactam]] + IV [[cipro]]/[[levo]]		* [[Cefepime]], [[Imipenem]], '''OR''' [[Piperacillin/Tazobactam]] + IV [[cipro]]/[[levo]]
	* [[~~Cefipime~~]], [[imipenem]], '''OR''' [[piperacillin-tazobactam]] + [[gent]] + [[azithromycin]]		* [[Cefepime]], [[imipenem]], '''OR''' [[piperacillin-tazobactam]] + [[gent]] + [[azithromycin]]
	* [[~~Cefipime~~]], [[imipenem]], '''OR''' [[piperacillin-tazobactam]] + [[gent]] + [[cipro]]/[[levo]]		* [[Cefepime]], [[imipenem]], '''OR''' [[piperacillin-tazobactam]] + [[gent]] + [[cipro]]/[[levo]]

Hoxbox: /* Healthy */

2019-10-20T12:20:30Z

Healthy

← Older revision		Revision as of 12:20, 20 October 2019
Line 2:		Line 2:
	''Coverage targeted at [[S. pneumoniae]], [[H. influenzae]]. [[M. pneumoniae]], [[C. pneumoniae]], and [[Legionella]]		''Coverage targeted at [[S. pneumoniae]], [[H. influenzae]]. [[M. pneumoniae]], [[C. pneumoniae]], and [[Legionella]]
	====Healthy====		====Healthy====
	*[~~[Clarithromycin~~]~~] XL 1000mg PO QD x7d '''OR'''~~		From IDSA 2019 guidelines <ref> Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America [https://www.atsjournals.org/doi/full/10.1164/rccm.201908-1581ST Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67] </ref>
	*~~[[Azithromycin]] 500mg PO day~~ 1, ~~250mg on days 2-5 '''OR'''~~
	*~~[[Doxycycline]] 100mg BID x 10-14d~~ (~~2nd line choice~~)		If no comorbidities (chronic heart, lung, liver, or renal disease; diabetes mellitus; alcoholism; malignancy; or asplenia) and no or risk factors for MRSA or Pseudomonas aeruginosa (include prior respiratory isolation of MRSA or P. aeruginosa or recent hospitalization AND receipt of parenteral antibiotics (in the last 90 d)).

			Duration of therapy minimal of 5 days.

			*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).

	==== Unhealthy ====		==== Unhealthy ====
	~~''Chronic heart, lung, liver, or renal disease; DM, alcoholism, malignancy~~.''		Per IDSA 2019 <ref> Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America [https://www.atsjournals.org/doi/full/10.1164/rccm.201908-1581ST Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67] </ref> if have comorbidities or risk factors for MRSA or Pseudomonas aeruginosa:
	*[~~[Levofloxacin~~]~~] 750mg QD x5d '''OR'''~~
	*[[Moxifloxacin]] 400mg QD x7-14d '''OR'''		Combination therapy:
	*~~[[Amoxicillin~~/~~Clavulanate]] 2g BID '''~~AND~~'''~~		*amoxicillin/clavulanate 500 mg/125 mg three times daily, or amoxicillin/clavulanate 875 mg/125 mg twice daily, or 2,000 mg/125 mg twice daily, or a cephalosporin (cefpodoxime 200 mg twice daily or cefuroxime 500 mg twice daily); AND
	**[~~[Azithromycin~~]~~] 500mg day 1~~, ~~250mg days 2-5 '''~~OR~~'''~~
	**[[Doxycycline]] 100mg PO BID x 7-10 days '''OR'''		*macrolide (azithromycin 500 mg on first day then 250 mg daily, clarithromycin [500 mg twice daily or extended release 1,000 mg once daily]) (strong recommendation, moderate quality of evidence for combination therapy), or doxycycline 100 mg twice daily (conditional recommendation, low quality of evidence for combination therapy); OR
	**[[Clarithromycin]] 500mg PO BID x 7-10 days
			Monotherapy:
			*respiratory fluoroquinolone (levofloxacin 750 mg daily, moxifloxacin 400 mg daily, or gemifloxacin 320 mg daily) (strong recommendation, moderate quality of evidence).

	===Inpatient===		===Inpatient===
Line 24:		Line 32:
	====Community Acquired (Non-ICU)====		====Community Acquired (Non-ICU)====
	''Coverage against community acquired organisms plus [[M. catarrhalis]], [[Klebsiella]], [[S. aureus]]		''Coverage against community acquired organisms plus [[M. catarrhalis]], [[Klebsiella]], [[S. aureus]]

			*β-lactam (ampicillin + sulbactam 1.5–3 g every 6 h, cefotaxime 1–2 g every 8 h, ceftriaxone 1–2 g daily, or ceftaroline 600 mg every 12 h) '''PLUS'''
			**a macrolide (azithromycin 500 mg daily or clarithromycin 500 mg twice daily)'''OR'''
			**[[Doxycycline]] 100mg IV/PO BID (if contraindications to both macrolides and fluoroquinolones ) '''OR'''

	*[[Levofloxacin]] 750mg IV/PO once daily '''OR'''		*[[Levofloxacin]] 750mg IV/PO once daily '''OR'''
	*[[Moxifloxacin]] 400mg IV/PO once daily ~~'''OR'''~~		*[[Moxifloxacin]] 400mg IV/PO once daily
	*[[Ceftriaxone]] 1g IV once daily '''PLUS'''
	**[[Azithromycin]] 500mg IV/PO once daily '''OR'''
	**[[Doxycycline]] 100mg IV/PO BID

	====Hospital Acquired or Ventilator Associated Pneumonia====		====Hospital Acquired or Ventilator Associated Pneumonia====