Duration of therapy for high-severity CAP in adults

Review the patient’s response to empirical therapy for high-severity CAP and the results of investigations.

If a pathogen is identified in an adult with high-severity CAP, see Directed therapy for pneumonia for modification and duration of therapy.

For adults with high-severity CAP, if the patient is clinically stable, the minimum duration of therapy (intravenous + oral) is 5 days; for azithromycin (which has a long intracellular half-life), the minimum duration of therapy is 3 to 5 daysLan, 2020Rattanasuwan, 2021.

Patients with endocarditis, melioidosis, meningitis, lung abscess, parapneumonic effusion or empyema require a longer duration of therapy.

For strategies to prevent further episodes of pneumonia, see Prevention of CAP in adults.