Severity
(classification)

1st line oral/iv antibiotics

Anaphylactic penicillin allergy
(see explanatory notes)

A

Minor to moderate infection

Review doses in renal impairment

AMOXICILLIN 500mg po tds

Treatment duration : typically 7 days

DOXYCYCLINE 200mg po od

Treatment duration : typically 7 days

B

Moderate to severe infection

Review doses in renal impairment

AMOXICILLIN 500mg po tds
Plus
DOXYCYCLINE 200mg po od

If prior treatment with either Amoxicillin or Doxycycline, use:
CO-AMOXICLAV 625mg po tds as monotherapy

If poor clinical response DISCUSS with specialist PHYSICIAN or  MICROBIOLOGIST 

Treatment duration: typically 7 days

DOXYCYCLINE 200mg po od as monotherapy

Treatment duration: typically 7 days

C

Severe life threatening infection

 Review doses in renal impairment

 CO-AMOXICLAV 1.2g iv tds

If atypicals suspected refer to community acquired pneumonia category C guideline 

If patient has Bronchiectasis discuss with specialist PHYSICIAN or  MICROBIOLOGIST. N.B. Antipseudomonal antibiotic is likely to be required

Treatment duration: 7 - 10 days

Discuss with specialist PHYSICIAN or MICROBIOLOGIST

Treatment duration: 7 - 10 days

IV to Oral Switch(explanatory notes)

CO-AMOXICLAV 625mg po tds (unless lab results indicate otherwise) typically for a total of 7- 10 days therapy

DOXYCYCLINE 200mg po od for typically 7-10 days total therapy. If contra-indicated discuss with specialist PHYSICIAN or MICROBIOLOGIST