What are the core measures for Pneumonia (infection of the lungs)?

From the Guidelines

Pneumonia core measures should prioritize administering appropriate antibiotics within 6 hours of arrival, obtaining blood cultures before starting antibiotics, assessing oxygenation status, and providing pneumococcal and influenza vaccinations when indicated, as these measures have been shown to improve morbidity, mortality, and quality of life outcomes 1. The key components of pneumonia core measures include:

• Administering appropriate antibiotics within 6 hours of arrival, with empiric antibiotic therapy typically including a respiratory fluoroquinolone or a combination of a beta-lactam plus a macrolide 1
• Obtaining blood cultures before starting antibiotics to identify specific organisms for targeted therapy 1
• Assessing oxygenation status to determine the need for supplemental oxygen and to manage patients who require mechanical ventilation 1
• Providing pneumococcal and influenza vaccinations when indicated to prevent future infections in vulnerable patients 1 These measures are crucial because they address the most critical aspects of pneumonia care that impact mortality and recovery, and have been consistently recommended by guidelines for the management of adult lower respiratory tract infections 1 and hospital-acquired, ventilator-associated, and healthcare-associated pneumonia 1. Some important considerations for pneumonia diagnosis and treatment include:
• Using a comprehensive medical history and physical examination to define the severity of pneumonia and to exclude other potential sources of infection 1
• Obtaining a chest radiograph to define the severity of pneumonia and the presence of complications 1
• Measuring arterial oxygenation saturation to determine the need for supplemental oxygen 1
• Collecting blood cultures to identify the presence of either pneumonia or extrapulmonary infection 1
• Obtaining samples of lower respiratory tract secretions to guide antibiotic therapy 1

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Pneumonia Core Measures

• Pneumonia is a significant source of hospital admissions and mortality, with community-acquired pneumonia (CAP) being a major contributor 2, 3.
• The treatment of CAP often involves the use of antibiotics, with beta-lactams and macrolides being common choices 2, 4, 5.
• The choice of antibiotic can depend on various factors, including the severity of the pneumonia, the presence of comorbidities, and the local resistance patterns of bacterial pathogens 3, 5.

Treatment Options

• Azithromycin and doxycycline are two antibiotics that are often used in combination with beta-lactams to treat CAP 2, 4, 5, 6.
• Studies have shown that the use of azithromycin or doxycycline in combination with beta-lactams can be effective in treating CAP, with some studies suggesting that azithromycin may be associated with better outcomes 4, 5.
• However, other studies have found that doxycycline may be associated with lower mortality rates and improved outcomes in certain patient populations 2, 6.

Key Findings

• A study published in 2023 found that the use of doxycycline or azithromycin in combination with beta-lactams resulted in similar outcomes for patients with severe CAP 2.
• A multicenter matched cohort study published in 2025 found that azithromycin was associated with lower mortality and more hospital-free days compared to doxycycline in combination with beta-lactams 5.
• A retrospective observational cohort study published in 2022 found that the use of doxycycline as part of guideline-concordant antibiotic therapy was associated with lower 30- and 90-day mortality rates 6.