skip to main content

Community-Acquired Pneumonia — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRespiratory InfectionCommunity-Acquired PneumoniaSCE Infectious Diseases

A 60-year-old man with COPD is admitted with a 5-day history of productive cough, fever, and breathlessness. Chest X-ray shows right lower lobe consolidation. CURB-65 score is 3 (confusion, urea 9.5 mmol/L, respiratory rate 32). He has a penicillin allergy (urticaria). What is the most appropriate empirical antibiotic?

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

Reveal the answer and explanation

Correct answer: C — IV Levofloxacin 500 mg once daily

CURB-65 score ≥3 indicates severe community-acquired pneumonia requiring hospital admission and IV antibiotics. The standard regimen is IV Co-amoxiclav or IV Benzylpenicillin plus a macrolide. However, this patient has penicillin allergy (urticaria = moderate allergic reaction). A respiratory fluoroquinolone (Levofloxacin) is the recommended alternative for severe CAP with penicillin allergy. Meropenem is reserved for more complex scenarios.

Reference: NICE NG138 2023 – Pneumonia (community-acquired): antimicrobial prescribing; BTS 2015 – Guidelines for management of CAP