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Community-Acquired Pneumonia Severity Assessment — ABIM Board MCQ

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ModerateInfectious DiseasesCommunity-Acquired Pneumonia Severity AssessmentABIM Board

A previously healthy 38-year-old is treated as an outpatient for radiographically confirmed community-acquired pneumonia. There is no recent antibiotic exposure, comorbidity or local contraindication. Which empiric regimen is appropriate?

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Correct answer: D — Use high-dose amoxicillin as monotherapy

The best answer is “Use high-dose amoxicillin as monotherapy”. For an otherwise healthy outpatient, amoxicillin is an appropriate first-line option; doxycycline is another. A macrolide alone depends on low local pneumococcal resistance. Routine MRSA or antipseudomonal therapy is excessive, ciprofloxacin is not a respiratory fluoroquinolone, and metronidazole lacks standard CAP coverage.

Reference: 2019 ATS/IDSA Guideline for Community-Acquired Pneumonia in Adults: https://www.idsociety.org/practice-guideline/community-acquired-pneumonia-cap-in-adults/