Pneumonia - community acquired (CAP)

The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.

Where laboratory susceptibility reports recommend that increased dosing is required for specific antimicrobials in relation to organism susceptibility, please refer to local guidelines.

Treatment at home - CRB-65 score of 0-2
Amoxicillin
Amoxicillin 500mg capsules

500mg every 8 hours for 5 days.

For penicillin allergy, or if atypical infection is suspected.

Doxycycline
Doxycycline 100mg capsules

200mg on day 1, then 100mg daily for 5 days treatment in total.

For penicillin allergy in pregnancy.

Erythromycin
Erythromycin 250mg gastro-resistant tablets

500mg 4 times a day for 5 days.

Prescribing Notes:

The CRB-65 scale can be used in community in conjunction with clinical judgement to help assess the need for hospital admission and risk of death due to pneumonia. One point is given for each indicator; 0 low risk, consider home based care, 1-2 intermediate risk, consider hospital assessment or admission, ≥3 urgent hospital admission.

  • Confusion AMT <8
  • Respiratory Rate ≥ 30/min
  • BP diastolic ≤ 60mmHg or systolic <90mmHg
  • 65 years or older

Additional notes

  • May be diagnosed at home (in the absence of chest X-ray) if there are symptoms of lower respiratory tract illness plus systemic features plus focal signs.
  • Patients that fail to improve within 48 hours should be considered for hospital admission or chest X-ray.
  • If clinically required courses may be extended to 10 days in total.

History Notes

30/07/2026

Regional formulary chapter launched.