Community Acquired Pneumonia — UKMLA MCQ

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MediumRespiratory MedicineCommunity Acquired PneumoniaUKMLA MRCP Part 1 MRCEM SBA PARA PSA MRCGP AKT

A 70-year-old woman is admitted with pneumonia. She has a history of severe penicillin allergy (anaphylaxis). According to NICE NG138, what is the most appropriate intravenous antibiotic choice for severe community-acquired pneumonia in this patient?

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Correct answer: D — Levofloxacin

NICE NG138 recommends avoiding beta-lactam antibiotics (penicillins, cephalosporins) in patients with a history of anaphylaxis. For severe community-acquired pneumonia (CAP) requiring IV treatment in such patients, a fluoroquinolone like Levofloxacin is a recommended option, often combined with an agent covering atypical pathogens if not already covered (though levofloxacin has atypical coverage). Clarithromycin alone is typically for mild-moderate CAP. Vancomycin is usually reserved for suspected MRSA. Ceftriaxone and Benzylpenicillin are beta-lactams and contraindicated.

Reference: NICE NG138: Pneumonia in adults