Hospital-Acquired Pneumonia — RACP Adult Medicine MCQ

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

EasyInfectious DiseasesHospital-Acquired PneumoniaRACP Adult Medicine

A 72-year-old man with COPD develops hospital-acquired pneumonia (HAP) 5 days after admission for an exacerbation. He has not been mechanically ventilated. He has no risk factors for multidrug-resistant organisms. What is the recommended empirical antibiotic for non-severe HAP in Australia?

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

Reveal the answer and explanation

Correct answer: A — Piperacillin-tazobactam

For non-severe HAP without risk factors for MDR organisms (no prior IV antibiotics, no MDR colonisation, no prolonged hospitalisation >5 days before HAP onset), eTG recommends amoxicillin-clavulanate IV or ceftriaxone. For moderate-severe HAP or patients with risk factors for MDR organisms, piperacillin-tazobactam is first-line. Meropenem is reserved for suspected ESBL-producing or AmpC organisms. Vancomycin/linezolid is added only for suspected MRSA. De-escalation based on culture results is a key antimicrobial stewardship principle. HAP is defined as pneumonia developing ≥48 hours after hospital admission.

Reference: eTG – 2025 – Antibiotic Guidelines; ACSQHC – 2024 – Antimicrobial Stewardship