Drugs that can be used for out patient treatment of community acquired pneumonia are:
Azithromycin This new azalide congener of erythromycin has an expanded spectrum, improved pharmacokinetics, better tolerability and drug interaction profiles. It is more active than other macrolides against H. influenzae, but less active against gram-positive cocci. High activity is exeed on respiratory pathogens-Mycoplasma, Chlamydia pneumoniae, Legionella, Moraxella and on others like Campylobacter, Ch. trachomatis,H. ducreyi, Calymm, granulomatis, N. gonorrhoea However, it is not active against erythromycin.resistant bacteria. Penicillinase producing Staph aureus are inhibited but not MRSA. Good activity is noted against MAC. Because of higher efficacy, better gastric tolerance and convenient once a day dosing azithromycin is now preferred over erythromycin as first choice drug for infections such as: (a) Legionnaires&; pneumonia: 500 mg OD oral/ i.v. for 2 weeks. Erythromycin or a FQ are the alternatives. (b) Chlamydia trachomatis: nonspecific urethritis and genital infections in both men and women- 1 g single dose is curative, while 3 weekly doses are required for lymphogranuloma venereum. It is also the drug of choice for chlamydia! pneumonia and is being preferred over tetracycline for trachoma in the eye. (c). Donovanosis caused by Calymmatobacterium granulomatis: 500 mg OD for 7 days or 1.0 g weekly for 4 weeks is as effective as doxycycline. (d) Chancroid and PPNG urethritis: single 1 .0 g dose is highly curative. The other indications of azithromycin are pharyngitis, tonsillitis, sinusitis, otitis media, pneumonias, acute exacerbations of chronic bronchitis, streptococcal and some staphylococcal skin and soft tissue infections. In combination with at least one other drug it is effective in the prophylaxis and treatment of MAC in AIDS patients. Other potential uses are in typhoid, toxoplasmosis and malaria. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:730,731
Ceftriaxone
Cefazolin
Imipenem
Azithromycin
Chemotherapy