Community-Acquired

Consult

Consider Respirology/Thoracic Surgery and Infectious Diseases consultation

Pleural Drainage

Chest tube drainage

Antibiotics

Ceftriaxone 2 g IV q24h

AND

Metronidazole 500 mg PO BID

ADD

Vancomycin (if MRSA suspected)

Can usually be discontinued if blood and other relevant cultures are negative for MRSA

Severe Cephalosporin Allergy

Moxifloxacin 400 mg PO/IV q24h

OR

Clindamycin 450 mg PO TID

ADD

Vancomycin (if MRSA suspected)

Can usually be discontinued if blood and other relevant cultures are negative for MRSA

Duration

3-6 weeks

Oral Step-Down

Antibiotics with good oral availability should be administered orally unless contraindicated: metronidazole, moxifloxacin, ciprofloxacin, and clindamycin

Amoxicillin-clavulanate can be used once adequate source control and clinical improvement