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LWI 1.1 Community-acquired pneumonia (CAP) - unknown pathogen - mild (AMBU 0-1)

Content version
U-286.2
Updated
10/20/2025 - 14:11

Recommendations

≥ 18 years
Dosage Remarks
1st choice
amoxicillin oral 500 mg tds for 3 days

- If the patient has not clinically improved and does not meet clinical stability criteria* on day 3, extend the total antibiotic duration to 5 days.

- If the patient is immunocompromised, then the treatment duration is 5 days.
2nd choice
doxycycline oral loading dose 200 mg, then 100 mg once daily for 7 days

Comments

Clinical stability criteria

  • Temperature < 37.8 °C
  • Pulse < 100 bpm
  • Respiratory rate < 24 breaths per minute
  • SpO2 > 90% (without mechanical ventilation, without an oxygen mask; oxygen delivery via nasal cannula is allowed)
  • Systolic blood pressure > 90 mmHg
  • No signs of delirium

AMBU-65 score

Treatment depends on the severity of the pneumonia. This is based on the number of criteria of the AMBU-65 score that the patient meets:

AMBU-65 score:

  • Respiratory rate > 30 per minute
  • Mental state: recent disorientation in time, place or person
  • Blood pressure systolic < 90 mmHg and/or diastolic < 60 mmHg
  • Urea > 7 mmol/L
  • Age > 65 years

A Legionella rapid test is performed within < 24 hours after admission (during working hours) in cases of:

  • risk factors for Legionella (recent travel abroad, during a Legionella outbreak, or failure to improve on therapy)
  • AMBU-65 score greater than or equal to 2

For information about influenza virus (flu): see LWI 4 Pneumonia: (viral) influenza

Adjust antibiotics according to culture results where possible.