From the FDA Drug Label
Adults Moderate to Severe Pneumonia due to S. pneumoniae, P. aeruginosa*, K pneumoniae, or Enterobacter species 1-2 g IV Every 8-12 hours 10
- For Pseudomonas aeruginosa, use 2 g IV every 8 hours The recommended dosage for IV monotherapy for pneumonia is 1-2 g IV every 8-12 hours for 10 days, depending on the causative organism. Key points:
- The dosage may vary based on the specific organism causing the pneumonia.
- The recommended duration of treatment is 10 days. 1
From the Research
Intravenous (IV) monotherapy with a respiratory fluoroquinolone such as levofloxacin (750 mg IV once daily) or moxifloxacin (400 mg IV once daily) is recommended for non-ICU patients with community-acquired pneumonia (CAP) without risk factors for drug-resistant pathogens. This recommendation is based on the most recent and highest quality study available, which suggests that fluoroquinolones are effective against a wide range of pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus 2.
Key Considerations
- For patients with severe pneumonia or risk factors for resistant organisms, combination therapy rather than monotherapy is preferred 3.
- Treatment duration typically ranges from 5-7 days, with transition to oral therapy once the patient shows clinical improvement (stable vital signs, ability to take oral medications, and normal mental status) 4.
- Therapy should be tailored based on local resistance patterns, patient allergies, and clinical response, with de-escalation to targeted therapy if a pathogen is identified through diagnostic testing 5.
Alternative Options
- A beta-lactam like ceftriaxone (1-2 g IV once daily) or ampicillin-sulbactam (1.5-3 g IV every 6 hours) can be used as an alternative to fluoroquinolones 6.
- Combination therapy with levofloxacin and ceftriaxone may be considered for patients with pneumonia caused by drug-resistant isolates 3.
Important Notes
- The choice of antibiotic should be guided by local resistance patterns and patient-specific factors, such as allergies and comorbidities 2.
- IV monotherapy works by targeting the likely causative pathogens of CAP, with fluoroquinolones providing coverage against typical and atypical pathogens, while beta-lactams target common bacterial causes like Streptococcus pneumoniae 6.