Recommend Coverage for Atypicals in Hospitalized Pneumonia Patients
You'll hear debate about whether it's okay to use a beta-lactam ALONE in hospitalized patients with community-acquired pneumonia (CAP).
Guidelines recommend using a beta-lactam (ceftriaxone, etc) plus a macrolide (azithromycin, etc)...OR a respiratory quinolone (levofloxacin, etc)...in non-ICU CAP patients. The idea is to help cover atypicals such as Mycoplasma or Legionella.
Now new evidence suggests that beta-lactam monotherapy is associated with similar 90-day mortality as a beta-lactam/macrolide combo or respiratory quinolone monotherapy.