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Mild CAP Outpatient — RACP Adult Medicine MCQ

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EasyRespiratoryMild CAP OutpatientRACP Adult Medicine

A 45-year-old previously healthy man presents with cough, fever (38.5°C), and left lower lobe consolidation on CXR. He is alert and oriented. RR 22, HR 90, BP 130/80, SpO₂ 96% on room air. CURB-65 score is 0 (age <65, no confusion, urea <7, RR <30, BP systolic >90). What is the most appropriate management setting?

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Correct answer: A — Outpatient management with oral antibiotics

CURB-65 score 0-1 indicates low-risk CAP suitable for outpatient management. Oral amoxicillin (1 g TDS for 5 days) is first-line for mild CAP without risk factors for atypical pathogens. If atypical cover needed: add doxycycline. A 5-day antibiotic course is non-inferior to 7-10 days for uncomplicated CAP (multiple RCTs). Follow-up CXR at 6 weeks for smokers/age >50 to exclude underlying malignancy.

Reference: eTG Antibiotic – 2025 – CAP; BTS 2024 CAP