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Treatment of Lower Respiratory Tract Infection
Lower Respiratory T
Lower Respiratory T ract Infection
ract Infection
Bronchiolitis
Bronchitis
Pneumonia
Exacerbation of Chronic
Common Pathogens
Common Pathogens
Antibiotics usually are not indicated. May consider for otherwise healthy patients with persistent cough (>10 d) and evidence of bacterial infection, and in patients with underlying pulmonary diseases such as Cephalosporins
cystic fibrosis or bronchopulmonary dysplasia.
200 - 400 mg PO twice a day x 10 - 14 days Macrolides
Macrolides
500 mg once a day x 3 days total dose 1.5 g once a day x 4 days (total course 5 days) 250 - 500 mg PO twice a day for 7 - 14 days Clarithromycin 250 - 500 mg PO twice a day x 7 - 14 days Quinolones
Tetracyclines
Mild: 500 mg PO twice a day x 7 - 14 days Severe: 750 mg PO twice a day x 7 - 14 days Pathogen Specific Therapy
Oseltamivir, Amantadine, Rimantidine, Zanamivir. 400 mg PO on day one, then 200 mg PO once Erythromycin, Tetracycline, Clarithromycin, Azithromycin, Penicillins
Fluoroquinolone, Doxycycline, Methacycline. Co-trimoxazole, Amoxicillin/clavulanic acid, Erythromycin, Tetracycline, 500 mg PO three times a day x 10 - 14 days Cefuroxime, Cefotaxime, Ceftizoxime, Ceftriaxone, Cefuroxime axetil, Sulfonamides
Cefixime, Cefpodoxime, Fluoroquinolone, Clarithromycin, Azithromycin. Tetracycline, Erythromycin, Clarithromycin, Azithromycin, Tetracyclines
Erythromycin, Co-trimoxazole, Azithromycin, Clarithromycin.
Bronchiolitis treatment
Bronchodilator
Racemic epinephrine
Adult : 0.5mL diluted in 3 mL NS via nebulizer over 15 Pediatrics: 0.05 mL/kg diluted in 3 mL NS given via nebulizer over 15 min q1-2h 0.8 mg/kg/hour continuous aerosol administration for 12 - 18 hours/day x 3 - 7 days Infants: 20 mg/ml for 12 - 18 hours/day x 3 - 7 days. Pathogen Specific Therapy
Amoxicillin PO, Levofloxacin PO/IV, Gatifloxacin Ciprofloxacin PO/IV, Doxycycline PO/IV, Amoxicillin- PO/IV, Moxifloxacin PO, Cefotaxime IV, Cefuroxime Clavulanate PO, Azithromycin PO/IV, Clarithromycin PO/IV, Ceftriaxone IV, Cefpodoxime PO, Cefprozil PO. PO, Erythromycin PO/IV Clarithromycin PO, Doxycycline PO/IV, TMP-SMX Cefpodoxime, Cefprozil, Azithromycin, Cefotaxime, PO/IV, Levofloxacin PO/IV, Gatifloxacin PO/IV, Amoxicillin-Clavulanate PO, Cefuroxime axetile PO, Levofloxacin PO/IV, Gatifloxacin PO/IV, Moxifloxacin Cefpodoxime PO, Cefprozil PO, Azithromycin PO PO/IV, Doxycycline PO/IV, Erythromycin PO Methicillin-susceptible Staphylococcus aureus: Penicillinase-resistant penicillin, Cephalosporin, Vancomycin, Amoxicillin-Clavulanic acid, Ticarcillin-Clavulanic acid, Piperacillin-Tazobactam, Ampicillin/sulbactam, Imipenem or Meropenem, Clindamycin, Fluoroquinolone, Penicillin G or V Methicillin-resistant Staphylococcus aureus: Vancomycin +/- gentamicin +/- rifampin, Cotrimoxazole, Fluoroquinolone, Minocycline. Less serious infection: Ciprofloxacin 500 mg PO twice a day. Serious infection: Ceftazidime 2 g IV 3 times a day, Cefepime 2 g IV twice a day, Piperacillin 4 g IV 6 times a day, Ticarcillin 3 - 4 g IV 4 times a day, Imipenem 500 - 1000 mg IV 4 times a day, Ciprofloxacin 400 mg IV 2 - 3 times a dayAztreonam 1 g IV 3 times a day. Any above plus: Gentamicin or Tobramycin 1.5 mg/kg IV 3 times a day or 57 mg IV once a day or Amikacin 7.5 mg/kg IV twice a day. Tetracycline, Erythromycin, Clarithromycin, Azithromycin, Fluoroquinolone.
; Pneumonia (Community Acquired, Hospital Acquired)

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