Parenteral antibiotic regimens for CAP in residents of an aged-care facility
For CAP in residents of an aged-care facility who are treated in the facility, if parenteral empirical antibiotic therapy is appropriate, use:
ceftriaxone 1 g intravenously, daily1; see advice on patient review and duration of therapy. ceftriaxone
If oral, enteral or intravenous antibiotic therapy is not appropriate for CAP in residents of an aged-care facility, use:
ceftriaxone 1 g intramuscularly, daily; see advice on patient review and duration of therapy. ceftriaxone
Ceftriaxone is not approved for subcutaneous administration in Australia, but some research supports its use by this routeGallardo, 2017Muntendam, 2016Renoncourt, 2023.
If the resident has improved with parenteral therapy, switch to oral or enteral therapy (see Guidance for intravenous to oral switch for guidance on when to switch to oral therapy). For oral or enteral regimens, see Oral antibiotic regimens for CAP in residents of an aged-care facility.
For patients who have had a nonsevere (immediate or delayed) hypersensitivity reaction to a penicillin, use ceftriaxone at the dosage above.
For patients who have had a severe immediate2 hypersensitivity reaction to a penicillin, ceftriaxone (at the dosage above) can be considered if a beta-lactam antibiotic is strongly preferred (for considerations, see Severe immediate hypersensitivity: Implications of cross-reactivity between penicillins and cephalosporins).
For patients who have had a severe immediate2 hypersensitivity reaction to a penicillin in whom ceftriaxone is not used, or for patients who have had a severe delayed3 hypersensitivity reaction to a penicillin, seek expert advice.