Pneumonia caused by Mycoplasma pneumoniae, Chlamydophila (Chlamydia) pneumoniae or C. psittaci

Metlay, 2019Uranga, 2016

Chlamydophila (Chlamydia) psittaci pneumonia is a notifiable condition. Report cases of C. psittaci pneumonia to the local public health authority – see the Psittacosis – CDNA National Guidelines for Public Health Units and see also Contact details for health departments and public health units.

In adults with pneumonia caused by Mycoplasma pneumoniae, Chlamydophila (Chlamydia) pneumoniae or C. psittaci, use:

1doxycycline 100 mg orally, 12-hourly for 7 days1 doxycycline doxycycline doxycycline

OR

2azithromycin 500 mg orally, daily for 3 days azithromycin azithromycin azithromycin

OR

2clarithromycin 500 mg orally, 12-hourly for 7 days. For dosage adjustment in adults with kidney impairment, see clarithromycin dosage adjustment. clarithromycin clarithromycin clarithromycin

In children with pneumonia caused by M. pneumoniae, C. pneumoniae or C. psittaci, use:

1azithromycin 10 mg/kg up to 500 mg orally, daily for 3 daysazithromycinazithromycin azithromycin

OR

2clarithromycin 7.5 mg/kg up to 500 mg orally, 12-hourly for 7 daysclarithromycinclarithromycin clarithromycin

OR

2doxycycline orally, 12-hourly for 7 days2 doxycycline doxycycline doxycycline

child less than 21 kg: 2.2 mg/kg3

child 21 to less than 26 kg: 50 mg

child 26 to 35 kg: 75 mg

child more than 35 kg: 100 mg.

If oral therapy is not tolerated or there are concerns about absorption in adults and children with pneumonia caused by M. pneumoniae, C. pneumoniae or C. psittaci, use:

azithromycin 500 mg (child: 10 mg/kg up to 500 mg) intravenously, daily for 3 days. azithromycin azithromycin azithromycin

For management of patients who are not improving, see (as relevant):

General strategies to prevent further episodes of pneumonia in adults are outlined in Prevention of CAP in adults. For strategies to prevent hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP), see Prevention of HAP or Prevention of VAP.

1 An oral liquid formulation of doxycycline is not marketed in Australia but is available via the Special Access Scheme. For formulation options for people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return
2 An oral liquid formulation of doxycycline is not marketed in Australia but is available via the Special Access Scheme. For formulation options for children, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return
3 When used short term (eg less than 21 days), doxycycline has not been associated with tooth discolouration, enamel hypoplasia or bone deposition so can be used in children of all ages.Return