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Community-Acquired Pneumonia — ABIM Board MCQ

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HardInfectious DiseasesCommunity-Acquired PneumoniaABIM Board

A hospitalized patient with nonsevere CAP is afebrile, hemodynamically stable, eating normally and has improving oxygenation after 48 hours of ceftriaxone plus azithromycin. Cultures are negative and no resistant-pathogen risk is present. Which step is appropriate?

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Correct answer: A — Switch to an active oral regimen while completing a stability-guided total course

The best answer is “Switch to an active oral regimen while completing a stability-guided total course”. Clinical stability and oral absorption permit intravenous-to-oral conversion; route alone does not determine duration. Total treatment is generally at least five days and guided by continued stability, pathogen and complications. Radiographic clearing lags clinical recovery, while negative cultures do not prove viral disease or create an indication for empiric MRSA therapy.

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