Guidelines for the management of community-acquired pneumonia in adults. Italian Society of Pneumology. Italian Society of Respiratory Medicine. Italian Society of Chemotherapy.
In general practice Community-acquired Pneumonia (CAP) is most often treated on an empyrical basis. Therefore, it is of the utmost importance to know the epidemiology of respiratory pathogens in order to give some guidelines for the empirical management of CAP. At present in cases of mild and moderate severity, ampicillin or amoxycillin, preferably in association with sulbactam and clavulanic acid respectively, and macrolides are the antibiotics of first choice. The latter can be an alternative to beta-lactams when Legionella, Mycoplasma and Chlamydia are the suspected etiologic agents or when patients are allergic to penicillins. They can also be used in combination with beta-lactams when etiological diagnosis is extremely uncertain. The course and severity of the disease, a chest radiograph, the results of microbiological and other laboratory examinations will determine the choice of further antibiotic treatment and other therapeutic measures, if necessary.