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Community-Acquired Pneumonia — UKMLA MCQ

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ModerateRespiratory MedicineCommunity-Acquired PneumoniaUKMLAMRCGP AKTPARA

A 45-year-old man is diagnosed clinically with community-acquired pneumonia. He is haemodynamically stable, has a CRB65 score of 0 and is suitable for community management. He has no drug allergies, relevant comorbidity or recent antibiotic exposure, and there are no features suggesting an atypical pathogen. Which oral antibiotic regimen is first-line?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Amoxicillin 500 mg three times daily for 5 days

The correct answer is C. NICE recommends oral amoxicillin 500 mg three times daily for 5 days as first-line treatment for low-severity community-acquired pneumonia in adults. This patient has a CRB65 score of 0, is clinically stable and has no factor making amoxicillin unsuitable. Doxycycline and clarithromycin are alternatives for penicillin allergy or when amoxicillin is unsuitable, such as when an atypical pathogen is suspected. Co-amoxiclav provides unnecessarily broad cover and is not first-line for uncomplicated low-severity disease. Levofloxacin is also not a recommended first-line community regimen and should not be used when a narrower-spectrum recommended antibiotic is appropriate.

Reference: NICE. Pneumonia: diagnosis and management (NG250), section 1.6 and Table 1: antibiotics for treating community-acquired pneumonia in adults. 2025. https://www.nice.org.uk/guidance/ng250/chapter/recommendations