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Moderate CAP — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesModerate CAPRACP Adult Medicine

A 55-year-old man with moderate-severity community-acquired pneumonia (CURB-65 score 2) requires hospital admission. He has no penicillin allergy and no risk factors for resistant organisms. Sputum Gram stain shows gram-positive diplococci. What is the most appropriate empirical antibiotic regimen?

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Correct answer: D — Benzylpenicillin IV plus doxycycline oral

Per eTG Antibiotic 2025, moderate-severity CAP (CURB-65 2) requires IV benzylpenicillin (providing S. pneumoniae coverage as suggested by gram-positive diplococci) plus oral doxycycline (atypical coverage). This is the recommended empirical regimen for moderate CAP in Australian guidelines. Ceftriaxone is reserved for high-severity CAP.

Reference: eTG Antibiotic – 2025 – Community-Acquired Pneumonia in Adults