treatment of pneumococcal pneumonia
Pneumococcal pneumonia is generally treated with amoxycillin, ampicillin or co-amoxiclav.
For severe infections:
- intravenous antibiotics e.g. ampicillin or co-amoxiclav. Oral amoxicillin or augmentin can be used when the pneumonia is resolving clinically and the patient is apyrexial.
For mild-moderate infections:
- amoxicillin 500mg-1g tds for 10-14 days*
- in patients allergic to penicillin, a suitable alternative is erythromycin 500mg qds PO or clarithromycin 500mg bd** PO (1)
Alternative treatments in penicillin allergy include erythromycin or cefuroxime (but note 10% cross-sensitivity).
- pneumococcal vaccination
- *BTS guidelines recommend adequate dosing of amoxicillin to cover intermediate-resistant strains of Strep pneumoniae
- ** clarithromycin may be substituted for those with gastrointestinal intolerance to oral erythromycin and also has benefit of twice daily dosage
- Thorax 2001;56 (suppl IV).
- Drugs and Therapeutics Bulletin (1998), 36 (9), 65-72.
Last reviewed 01/2018