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Legionella Pneumonia — SCE Infectious Diseases MCQ

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HardRespiratory InfectionLegionella PneumoniaSCE Infectious Diseases

A patient in intensive care has shock and severe confirmed Legionella pneumophila pneumonia. QTc is 430 ms and there are no interacting medicines. Which early definitive regimen best reflects BTS guidance?

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

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Correct answer: A — IV levofloxacin with IV clarithromycin for the first few days

For high-severity confirmed Legionella pneumonia BTS recommends a fluoroquinolone; a macrolide can be combined during the first few days. Combination QT liability must be reviewed. Beta-lactam monotherapy does not cover intracellular Legionella, and rifampicin is not used alone.

Reference: BTS CAP guideline: https://brit-thoracic.org.uk/document-library/guidelines/pneumonia-adults/bts-guidelines-for-the-management-of-community-acquired-pneumonia-in-adults-2009-update/