Community-acquired pneumonia (outpatient): empiric antibiotic therapy
What the major U.S. guidelines recommend, with a link to verify each at the source. A quick-reference summary for clinicians, not medical advice.
Healthy outpatients, no comorbidities: amoxicillin 1 g PO TID (strong, moderate-quality evidence), OR doxycycline 100 mg PO BID (conditional, low-quality), OR a macrolide (azithromycin 500 mg x1 then 250 mg daily, or clarithromycin 500 mg BID) only where local pneumococcal macrolide resistance is under 25% (conditional, moderate-quality). Treat at least 5 days, continued until clinically stable.
Verify at ATS/IDSA →Outpatients with comorbidities (chronic heart/lung/liver/renal disease, diabetes, alcoholism, malignancy, asplenia): combination of amoxicillin/clavulanate (875/125 mg BID) or a cephalosporin (cefpodoxime 200 mg BID, cefuroxime 500 mg BID) PLUS a macrolide or doxycycline 100 mg BID; OR fluoroquinolone monotherapy: levofloxacin 750 mg, moxifloxacin 400 mg, or gemifloxacin 320 mg daily.
Verify at ATS/IDSA →