A 55-year-old man on ICU has community-acquired pneumonia. He is allergic to penicillin (documented anaphylaxis) and also has a documented severe alle...

Question

A 55-year-old man on ICU has community-acquired pneumonia. He is allergic to penicillin (documented anaphylaxis) and also has a documented severe allergy to fluoroquinolones (Stevens-Johnson syndrome). He requires treatment for severe CAP. What antibiotic regimen is appropriate?

Accepted Answer

IV ceftriaxone (low cross-reactivity with penicillin - may be used cautiously in non-anaphylactic allergy) plus IV clarithromycin; however if penicillin anaphylaxis risk is deemed too high, alternative options include IV meropenem (very low cross-reactivity

Answer

IV co-amoxiclav (contains a penicillin - contraindicated)

Answer

IV levofloxacin (fluoroquinolone - contraindicated)

Answer

No antibiotics can be given - the patient cannot be treated

Answer

Oral doxycycline alone

uk-fficm MCQ (SBA): CAP - Multiple Drug Allergies

A 55-year-old man on ICU has community-acquired pneumonia. He is allergic to penicillin (documented anaphylaxis) and also has a documented severe allergy to fluoroquinolones (Stevens-Johnson syndrome). He requires treatment for severe CAP. What antibiotic regimen is appropriate?