What is the first-line treatment for community-acquired pneumonia in adults?

The first-line treatment for community-acquired pneumonia (CAP) in otherwise healthy adults is primarily guided by the likely causative organisms and their sensitivities. Amoxicillin is effective against Streptococcus pneumoniae, the most common pathogen associated with CAP. It is preferred because it has a good safety profile, excellent efficacy, and is generally well-tolerated.

Doxycycline is also a suitable option for patients who may have atypical pathogens, such as Mycoplasma pneumoniae or Chlamydophila pneumoniae, which can be implicated in CAP. By including doxycycline, the treatment regimen covers both typical and atypical bacteria.

While levofloxacin is a fluoroquinolone that can be considered in certain cases, it is not typically necessary as a first-line treatment for uncomplicated CAP when more narrow-spectrum agents like amoxicillin or doxycycline are effective. Azithromycin can be used, especially if there is a concern for atypical pathogens, but it generally does not provide the same broad coverage as amoxicillin in initial treatment. Vancomycin is indicated primarily for more severe cases or when methicillin-resistant Staphylococcus aureus (MRSA) is suspected, which is not the case for most patients with