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Hospital-Acquired Pneumonia — SCE Infectious Diseases MCQ

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EasyHealthcare-Associated InfectionsHospital-Acquired PneumoniaSCE Infectious Diseases

A 62-year-old man develops hospital-acquired pneumonia on day 5 of admission. He has no prior antibiotic exposure, no MRSA risk factors, and no history of MDR organisms. He is not in the ICU. What is the recommended empirical antibiotic per NICE?

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Correct answer: D — IV Co-amoxiclav 1.2 g TDS (or local first-line HAP agent)

For early-onset HAP (≤5 days of admission) without risk factors for MDR organisms, NICE NG139 recommends a narrower-spectrum agent: IV Co-amoxiclav is commonly first-line. Broad-spectrum agents (Piperacillin/Tazobactam, Meropenem) should be reserved for late-onset HAP (>5 days), prior antibiotic exposure, known MDR colonisation, or ICU-associated pneumonia. Antibiotic stewardship principles emphasise starting with the narrowest effective agent and escalating only if needed.

Reference: NICE NG139 2019 – Healthcare-associated infections; BTS 2019 – HAP guidelines